HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8.30.2016 Permit Number:
I.
Building Peri iit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Comrrercial Residential >C
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 30 Lake Vista TRL, Apt 104, Port St Lucie, 34952
Legal Description: VISTA ST LUCIE BLDG 30 UNIT 104 (OR'i3869-2405)
Property Tax ID it: 3422-500-0410-000-7
Site Plan Name: Vista St Lucie
Project Name:
Setbacks Front Back: Right Side:,, Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
Replace L,kt for L,ke 1:S Ton 'Spt�� Sys wILt. Slew W4+.Gr-ive tve�3
RhZZM I S.5 See -A 1. S TUN �;y;ie:n w� Skw "Q44_
CONSTRUCTION INFORMATION: IJI
Additional work to be erformed underthis ermit-cheill -
� P apply:
ZHVAC Gas Tank ❑Gas Piping _ Shutters
11 Electric 0 Plumbing Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 2499.00
OWNER/LESSEE:
Name Barbara J Wilson
Address: 30 Lake Vista Trl
City: Port St Lucie
Zip Code: 34952 Fax:
Phone No.
E -Mail:
Windows/Doors
Roof = Roof pitch
S Ft. of First Floor: 680
Utilities'F�Sewer Septic Building Height: _
1111CONTRACTOR:
Name: -
Company: Airstron Inc
State:FL Address: 1559 SW 21st Ave
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
,City: Fort Lauderdale State: FL
Zip Code: 33312 Fax: 954-923-1654
Phone No. 954-321-1924
E -Mail: wpalladino@airstron.com
State or County License: CAG023473
j if value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
1.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFt)RMATION:
DESIGNER/ENGINEER: x 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: x Not Applicable
Name: Name:
Address: (Address:
City: City:
Zip: Phone: Zip: -- Phone:
I II
I certify that no work or installation has commenced prior to the igk uance of a permit.
St. Lucie County makes no representation that is granting a permit 1 vill authorize the permit holder to build the subject structure
which is in mntlict with any applicable Home Owners Association r es, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and r.view your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereL,, 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 Joins and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of ommencement may result in your paying twice for
improvements to your property. A Notice of Commence ent must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financ g, consult with lender or an attorney before
commencing work or recording vour Notice of Commeri;pment.
C .Z
Signature tl UWne�Contfactor as Agent for Owner
STATE OF FLORIDA
COUNTY OF A 1AIA /LC)
The fo Ding instry�pent Was ackp owledged before me
this [day of -tD &W-4.M'20JLby
�'r 1 pRse�te e�
(Name of person ac now edging )
(SignaLUr ubll tate o Fonda )
Personally Known ✓ OR Produced Identification
Type of Identification Produced
Commission No.
Notary Public State of Florida
`F Diane Johnson
X p my „ommiwien rr wa336
Revised 07/15/20 °'^ e,a e' oe aeaan
REVIEWS FRONT I ZONING I SUPERVISOR
COUNTER REVIEW REVIEW
DATE
COMPLETE
I INITIALS I I
S,gnature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF QLeWMU�
!he forgoing instrument was acknowledged before me
this Aday of AAAA 20 L� by
uES M P"Os &Cdz-
of person acknowledging)
a re o Notary Pq(hic- St a of Florida )
orally Known OR Produced Identification
of Identification Produced
No. N°Nry Publ1C(§iitaaill Flonla
f Diane Johnson
,..n FF 016376
VEGETATION I SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW
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