HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: Permit Number:1 Q1 —
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 1108 West Midway Road, Fort Pierce, Florida 34982
Legal Description: WMTE CITY BLK40 LOTS OTO 9INCL AND LOSTS 2D TO 27 INCLANDVAC ALLEY LYGSTWTI SO LOTS AND S 15 FT OF THAT PORTION OF CHARLOTTE ST LVG N OF AND ADI TO LOTS 0,7.&AND 9-LESS
THAT PART OF LOT 27 MPDAF:BEG SW COR OF LOT 27,TH N 0018 07 E25.28 FT,TH S44 2126 E35.57 FT TO S LI OF LOT 27,TH N 89 39.04 W 25 FT TO POB(R/W}(1.21 AC-52,827SF)
Property Tax ID#: 3404-501-0229-000-8 Lot No.6-9 20-27
Site Plan Name: Midway Road Baptist Church,Inc. Block No. 40
Project Name: Midway Road Baptist Church,Inc.
Setbacks Front Back: Right Side: Left Side.
DETAILED DESCRIPTION OF WORK: .
Demolition and removal of house, pump out and remove septic
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all appy:
HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers E Generator' 1:1 Roof Roof pitch
Total Sq. Ft of Construction: 600 SFt.of First Floor: 600
Cost of Construction:$ 2,450.00 Utilities:
Sewer Septic Building Height: one
OWNER/LESSEE: CONTRACTOR:
Name Midway Road Baptist Church,Inc. Name: Randle Lee Beckford
Address:1108 West Midway Road Company: L.E.B. Demolition&Consulting Contractors, Inc.
City: Fort Pierce State:FL Address: 7 Harbour Isle Drive East 204
Zip Code: 34982 Fax: City: Fort Pierce State:FL
Phone No.772 971-1566 Zip Code: 34949 Fax: 772 461-2225
E-Mail:laseted@gmail.com Phone No. 772 461-4545 Mobile 772 216-1286
Fill in fee simple Title Holder on next page(if different E-Mail: iwreckn@aol.com
from the Owner listed above) State or County License:i'26948
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.,
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:'
;L.
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: .' X Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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I certify that no work or installation has commenced prior to the issuance of a permit.
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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,injall respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
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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
commencing work or recording our Notice of Comm enceme t.
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Signature of Ow er/Lessee/Contractor as Agent for Owner Signature o tractor/License Holder
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF-.L.d• COUNTY OF----,--
The
F---,--The forgoing instr ent was acknowledge efore me The forgoing instrument was acknowledged before me
this l_day of a 20 LLby this s� day of January 20 _aby
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Randle Lee Becldb Y
Randle Lee Beckford
(Name of person acknowledging) (Name of person acknowledging) I
V/1 J7-QP'-A 0 A 1 �2� PA-
(Signature o0qotary Public-State of Florida) (Signature o otary'Public-State of"Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
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Commission No. r gWQFR P HESTER 'Commission No. � IN®ESTER
MY COMMISSION#FF912939 '';1 �' MY COMMISSION#FF912939
ExOREA August 26,20-49
August 19
Revised 07/15/2014 taoa oIs3 r>�daen«aryse (407)398 ' Floaa. ServimC rc
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DATE
COMPLETE
INITIALS �