HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST)BE COMPLETED FOR APPLICATION TO BE ACCEPTED J �i
Date: / ` �'/ Permit Number:
RECEIVEC
•
Building Permit Application .APR -`7.:2016
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line IYl NJboas
PROPOSED IMPROVEMENT LOCATION:
Address: lac&4- S.man Drive Lin i , 308
Legal Description: Gina winds C'ondorninjum_AT
.Property Tax ID#: 4-502- $04•' 00zq--�M0-5 Lot No.
Site Plan Name: Alen Re -n a_1 Block No.
Project Name: 41cla.p[sSV Re(1•} ,i
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION CSF WORK:
Remove and rcplaee Windows + doors w i-th i.m poucIF.
(3) vel ndpwS -
0�)SG bs
CONSTRUCTION.INFORMATION: .:
Additional work toa er orme under er t is permit-check a appy:
11HVAC []GasTank,:- E]Gas,P.'iping _Shutters Svindows-ppgrs
Electric Plumbing S'
Generator Roof
Total Sq. Ft of Construction: S . Ft: of First Floor:
Cost of Construction: $ 11 .'700 .00 Utilities: Sewer[]Septic Building Height:
OWNER/LESSEE:- CONTRACTOR:
Name_John+ Fl�.h 44e Name:Name: I,Wfd dmdc
Address:-[ .�pffi Drive, Unilzeo .Compan�c::Thl?..Mass Prae_&Si0Y1C�,lS
::City 1R,(�1 'f1MP [�'1 State:fL diiie�s+? '70;SE b1X1 aA4`WV
` Zip:Cotle {q> 7 Y :. 4:F x: n ja ctY State: EL
�! Phone,No 77�_. 22-9',, ,3433 dip Codem`3,•99-] Fax: 772.28b•04(0)
E-Mail:' 4 Phone No.14 1
772• Z$io •04 59
Fill in fee simple-Title Holder on next page(if different E-Mail: peirn its .n Lass arose @mai 1 .CDM
from the Owner listed above) State or County License: 1931,m3
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit tiiill authorize the permit holder to build the'subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws bran covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed,for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full co ricurrency'r'eview:'room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory,uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded;and posted cin the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or ttorney before
_commencing work or recording our Notice of Commencem
L"',
S
Signature of Owner/:Lessee/ ent ; ' Si a of ontractor Icense Holder . , ...
TATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Nartlh COUNTY OF y, i�rh'n
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of ffliWh 20 /t by this 2 day of 20 [ by
Jo hn 1 -Ilenn esy
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu Ic-State of Florida ) (Signature of Notary Publi State of Florida-)--
Personally Known OR Produced Identification Personally Known 7OR Produced Identification
Type of Identification Produced �L . („ Type of Identification Produced
Commission No: (Seal) Co'mmission:No. (Seal)., y
KEITH FINFROCK
SK
:_�' °" .• EITH FINFRO
MY COMMISSION#FF165768 MY COMMISSION #FF16 68
Revised'07/15/2014 °_ EXPIRES Ciet6ber-5,Zola
EXPIRES October 5 2 18
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