HomeMy WebLinkAboutBuilding Permit App ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
y
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 x Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 3000 NW Radcliffe Way
Legal Description: Riverbend (PB67-36)-RD RMs (Radcliffe Way and Baywood PI)(5.62 AC)
Property Tax ID#.. 4425-703-0053-000-1 Lot No.
Site Plan Name: Riverbend Block No.
Project Name: common meter Gazebo
Setbacks Front Back: Right Side: Left Side:
PEI
Existing meter combo for common areas- need to install new meter as developer had meter service
cancelled when project was completed
Vrd s
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itiona wor to e e owr ried under this permit—check all apply:
0HVAC 0 Gas Tank Gas Piping _Shutters ❑Windows/Doors
RElectric ❑ Plumbing Sprinklers El Generator E] Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 500.00 utilities:]Sewer Septic Building Height:
Name Riverbend Prop Owner's Assoc Name: Michael Pettengill
Address:15360 Barranca Pkwy Company: Electrical Connections
City: Irvine State:CA Address: 1205 SE Dixe Cutoff Rd
Zip Code: 92618 Fax: City: Stuart State:FL
Phone No. Zip Code: 34994 Fax: 772-283-5890
E-Mail: Phone No. 772-283-5792
Fill in fee simple Title Holder on next page(if different E-Mail: mike@eleconnections.com
from the Owner listed above) State or County License: EC 13001494
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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
commencing work or recordin vour Notice of Commencement.
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Signature of Owner/Lesse o ctor as Agent for O r Signature of Cont r/License Holder
STATE OF FLORIDA STATE OF FLO IDA ,rye
COUNTY OF — COUNTY OF
The fgrq�jng instr ent was acknowledged before me The fowing instru ent was acknowledged before me
this -d-ay of 20(7by this day of 20/7 by
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(Name of person acknowledging) (Name of person acknowledging)
(Signatu a of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identifica ion Pro y�p���ry pe of Identification Produced
t1?y P, KAREN COLS
Commission No. issioN#FFomm Immission No. �Y,: (Seal) KARENCOLE
5� :a EXPIRES*
MKch AIY WNIMiSStON a#FF 9T1203
1.4w..0 BOnCW TIVU Notify Publk ? :o EXPIRES:Mwch 10,2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS