HomeMy WebLinkAboutBuilding Permit Application a � 3 0
PERMIT# ISSUE DATE '
PLANNING & DEVELOPMENT SERVICES
•
- Building & Code Compliance Division
-- - BUILDING PERMIT
�R:5ff
SUB-CONTRACTOR AGREEMENT 'r-
932-
a\ S Z--`' IQ t C k---S: -S- 0 C. have agreed to be
(Company Name/Individual Name)
the P(C.,/L, r°V)ei Sub-contractor for'- .C) el0 e
(Type of Trade) (Primary Contractor)
For the project located at 4 9 4 q R- 2-1 a
(Project Street Address or Property Tax ID#)
It is understood that,if there is any change of status regarding our participation with the above mentioned
project,the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub-contractor notice.
CONYRACT01i S1 UR Qualifier) S RA TOR SIGN (Qualifler)
216c, �,� 14,iD I 4z rn
P NAME �—'� PRINT NAME
COUNTY CERTIFICATION NUAIBER COUNTY CERTIFICATION I\ BE
State of Florida,County of 15+ State of Florida,County of Q
The foregoing instrument was signed before Lme/this�day of The foregoing instrument
as signed before me this �C'� day of
{� 2011 by �d G 1 Ul. � 3L 2C/ r,by `IBJ "(i
who is personally known_or has produced a who is personally known_or ha roduced a
as identification. as identification.
_ Rm ublic State of Flodda STAbIP
_A2,&A t-4Ia('a4n J Slay
is re of_ o ry Public My Commission FF Oature Notary Public
o, Upkes'11/2012017
Print Name of Notary:Pub is Print Name of Notary Public
lis•.^r�, AUDREY B.HUMPHREY
?4 Y MY COMMISSION#FF 174772
Revised 11/16/2016 = = EXPIRES:March 6,2019
i •, o:
f3f, d Bonded Thru Notary Public Underwriters
SU.PPLEMENTA'L CONSTRUCTION LIEN LAVI%.INFOR'IVIATION :.
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name: Seacoast Bank
Address: Address:
City: State: City: start State: F1
Zip: Phone: Zip: 34995 Phone: 800ao6-9991
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 work or recording our Notice of Commencement.
T 6fillA
s
S'gha uref'Own e r%Less /Contractor as Agent for :*'fir_ Signature of Contractor/License Holder
STATE OF FLORIDA ?' `' STATE OF FLORIDA
o.
COUNTY OF COUNTY OF
The forgoing instru nt was acknowledged before �o o The forgoing instrument was acknowledged before me
this 19r—day of 20 LTby Z this day of 20 by
(Narnk of person acknowledging) io o Name of person acknowledging)
(Signature of NoPu State of Florida) (Signature of Notary Public-State of Florida)
Personally Known ' -OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �f r�1�/
Date: 2;2017 Permit Number: ! OJ' 0(o
Z' V
GIFU
RECEI
Building Permit Application
Planning and Development Services FEB /3 2017
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: Renovation
PROPOSED.[MPRO.VEMENT LOCATION ,:`:
Address: 4949 North Highway Al #211 Ft. Pierce, FI. 34949
Legal Description:
Property Tax ID#: ' — tfn( "Z ® �� — Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
__. _ .mak - ... _,..,' - j ..a.• -. _._ .. _ u. .aQ' - `-_ - - ,.1•''._
DETAILED DESCRIPTION .O.F WORK: :
See attached scope of work from A+ Plumbing Services Inc. Electrical service will be run to water
heater.
CONSTRUCT[ON I.NFORIVIATION
Additional work to be nertormed under this permit—check all appy:
HVAC Gas Tank E]Gas Piping M Shutters Windows/Doors
Electric Plumbing Sprinklers Generator F-1 Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ $4800 Utilities:Sewer]Septic Building Height:
0V1/N ER/LESSEE. CONTRACTOR:
W -
Name Robert G.Adolphe Name: Robert G.Adolphe,
Address:4949 North Highway AIA#211 Company: Owner
City: Ft. Pierce State:Fl_ Address: 4949 North Highway AIA#211
Zip Code: 34949 Fax: City: Ft. Pierce State:FI.
Phone No.407-716-0187 Zip Code: 34949 Fax:
E-Mail:bob.adolphe@gmail.com Phone No. 407-716-0187
Fill in fee simple Title Holder on next page(if different E-Mail: bob.adolphe@gmai1.com
from the Owner listed above) State or County License: FI. PE#42448.
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.