HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: C'► '®Qqq
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: 1940 North Old Dixie Highway, Fort Pierce, Florida 34946 aka 1940 North 3rd Street
Legal Description: HILLSIDE S/D LOTS 10 AND 11 (OR 3889-94)
Property Tax ID#: 2403-602-0010-000-4 Lot No.10-11
Site Plan Name: Crull Services, Inc. Block No.
Project Name: Crull Services, Inc.
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: i
Complete demolition and removal
CONSTRUCTION INFORMATION: {; l
Acid ltiona I work toe performed under this permit—check all that appy:
HVAC 0 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers F Generator El Roof Roof pitch
Total Sq. Ft of Construction: 442/777 SCI. Ft.of First Floor: 4421777
Cost of Construction:$ 2,450.00 Utilities:Sewer 13Septic Building Height: one
OWNER/LESSEE: CONTRACTOR:
Name Crull Services,Inc. Name: Randle Beckford
Address:81 Queens Road Company: L.E.B.Demolition&Consulting Contractors, Inc.
City: Fort Pierce State:Flodda Address: 7 Harbour Isle Drive East 204
Zip Code: 34949 Fax: City: Fort Pierce State:Florida
Phone No.772 465-7685 Zip Code: 34949 Fax: 772 461-2225
E-Mail:info@crullservices.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: 26948
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required:
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:,
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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
commencing wor r recording our Notice of Commencement.
s
Signature of Owner/ essee/Contractor as Agent for Owner Signature of Cont ctor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF—,u-- COUNTY OF-,--
The forgoing instrAment was acknowledge fore me The forgoing instrument was acknowledged before me
this??f—day of 20 by this 31 day of January 20 _a by
Randle Beckford 1 Randle Beckford
(Name of person acknowledging) (Name of person acknowledging)
(Signature ciVNotary Public-State of Florida) (Signature cVNotary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF912939 ; )v ;; 9 �sER P HES4ER ommission No. FF9,2 sGING"bffi) (ESTER
•'c MYCOMMISS ION,#FF91293 �': '"- MY COMMISSION#FF912939
EXPIRE
(407)398-0!S3 �rrrr
EXPIRES August 25 X119
fWndMo+a SenAw.corc (407)398-0!53 9n4M0on
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS