HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED JJ Q
Date: Permit Number:
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Building Permit 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 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 4404 Areca Palm Drive
Legal Description: CARDINAL GLADES BLK 4 LOT 2 (OR 1332-439)
Property Tax ID#: 2434-802-0026-000-9 Lot No. 2
Site Plan Name: Block No. 4
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
�•vuSTr�l( �-t X rJ � R2figP �oCZ -er��[CONSTRUCTION INFORMATION:
Additional work to be ertormed under t ispermit—check all apply:
HVAC LJ Gas Tank Gas Piping _Shutters a Windows/Doors
Electric Plumbing Sprinklers FIGenerator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
D O, .
Cost of Construction: $ 100D• Utilities:R_Sewer F�Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name John Carl Peterson Name: John Carl Peterson
Address:4404 Areca Palm Drive Company:
City: Fort Pierce State:FIL Address: 4404 Areca Palm Drive
Zip Code: 34982 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34982 Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
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 will authorize the permit holder to build the subject 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 or an attorney before
comme,pcing work or recording our Notice of Commencement.
—/,100 s
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gnature w r e Contractor as Agent for Owner S, nature of Contractor Li nse Holder
STATE OF FLORIDAz � STATE OF FLORIDA
COUNTY OF A LLo 1c COUNTY OF
The for oing instru ent w acknowledged before me The forgoing instru ent s acknowledged before me
this day of 20 f j�by this day of 20 LU_by
CA\M 0h)
( me of person�cknowledging) (N a of person acknowle ing)
(Signa ire of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida)
Personally Known V// OR Pr u ftificlglEN ,' N I E 8€�9on y Known " use Kigp NIELSEN
Type of Identification Produced `� Commission # FF h5fa37 '
lP�of entification Produ mmission # FF 115637
- y commission E xpires My Commission Expires
} %;E°� °'g° June 12, 2 1 ;;7„,o�P�` S e 1 2, 2018
Commission No. j 'on No. ,,.
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS