HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE 1,N�FO�MUST
/-BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: "T' /' / tP Permit.Number:_ OVA 12 //
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Building Permit Application a_ 2016
Planning and Development Services ;A1PR
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-15 78 Commercial Residential
PERMIT APPLICATION FOR:- To Select from dropbox, click arrow at the end of line vylndowg
dcoys
PROPOSED IMPROVEMENT LOCATION:
Address: 1004.4 SCL -ffi OCMn -Drive Unit- SO4-
.Legal Description: Sm winds c01'ldomini(.tms D 804:
Property Tax ID#: 4-�z W14 -clow-wo -9 Lot No.
Site Plan Name: I PBlock No.
Project Name: -1-e6h,esSV Residence,
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
tRernove and replace W i ndowS + doors vo%+h i rn pcXt.
CONSTRUCTION INFORMATION:
Additional work to be nertorme un derthis permit-check all appy:
HVAC Gas Tank , Gas Piping _Shutters Windows/Do`ors
Electric ❑ PlumbingSprinklers Generator Roof
-Total Sq. Ft of Construction: S . Ft. of First Floor.:
Cost of Construction:$ �-,vn .� Utilities:lnSewer Septic Building Height:.
OWN ER/LESSEE: CONTRACTOR:
._Name... O. .. .k... -- Name: 1�.Vid LQ.Pracle
Address1 Company TSP �:IaSS-°pra�cSSiotl'1C�_�S
Stater Adtlress' 357b"SF iX�'
Zip: ode 3 57 Fax a n /a City: ;�Q,r�',: State:FL
Phone No. -1-72-- 279- 31+33 Zip Code;,94897. "- Fax: 28(o O44p
E-Mail: Vitnre-S4V?77- 6) gMnA. r= Phone No. 112. 2.9fo•(3459
Fill in fee simple Title Holder on next page(if different E-Mail: i
from the Owner listed above) State or County License: 3
Lalue 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,perQ,nit will authorize.the permit holder to build the's'ubject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and 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 concurrency review 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-on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender r an attorney before
gornmencing work or recording our Notice of Commencement.
s
Signature o Owner/Lessee/A ent ;Signature of Contract License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of fnas-Ch 20 &by this22- day of_W6rCJL 20 -A,by
John 1 4ehhem _A11/0 A11/0 lapfa.c)4e
(Name of person acknowled ing) (Name of person acknowledging)
(Si nature of Notary Public-State of Florida) (Signature of Notary Public-:7
ublic- tate of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced �l_ Type of Identification Produced
Commission No. .. Commission No: H FINFROCK
KEITH FINFROCE
MY COMMISSION#FF16576
.oma? MY ., i .� ;, oF�,.` EXPIRES
'
Revised'07/I5/2014 ��orad"' EXPIRES October 5. 2;; " i (407)398-0153 `FldridallotaryService.com
(407)398-0153 FloridallotarySc-rv,rr.r:
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