HomeMy WebLinkAboutBuilding Permit Application r�
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1,Q5�d�37
RECEIV D MAY 31 2017
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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 Residential x
PERMITAPPLICATION FOR: Sfwttef ti
PROPa5ED,hMPR WEMENT'LaCATIQN ,
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Address: 250 SHINN RD,FORT PIERCE,FL 34945
Legal Description: 07 35 39 FROM INT OF C/L OF ORANGE AV AND W LI OF SE 1/4 RUN E ALG C/L 108 FT. TH
S 493 FT TO POB,TH E 208.71 FT,TH S 208.71 FT,TH W 208.71 FT,TH N 208.71 FTTO POB
Property Tax ID#:2307-422-0001-000-1 Lot No.
Site Plan Name: 250 SHINN RD Block No.�
Project Name:GARY&JANET PICKLESIMER
Setbacks Front Back: Right Side: Left Side:
DETAILED aCRIPTION'OF WOR , k � � , 8 . rpt F ;
r x t - ;ITr.,ekxz,;,• -�,ft ' •r.�,t Es v,„a
-Replace 1 Door - - -- -
`CONCTIO
STRUN INFORMATION
Additional work toa er orme under tis permit—c heck a appy:
❑_HVAC Ei Gas Tank Gas Pi in Shutters X Windows Doors
❑ p g ❑ /
Electric 0 Plumbing Sprinklers E Generator ❑Roof
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 3,000.00 Utilitles:lSewer EJSepticBuilding Height:
OWN,ERf LESSEE :z CONTRACTOR
Name GARY&JANET PICKLESIMER Name:DAN BECKNER
Address: 5328 I>ERFFO RD RD Company:PARADISE EXTERIORS,LLC
City: LAKELAND State: FL Address:1918 CORPORATE DR
Zip Code: 33810 Fax: City:BOYNTON BEACH State:FL
Phone No. (863)858-0970 Zip Code:33426 Fax:
E-Mail: Phone No. 561-732-0300
Fill in fee simple Title Holder on next page( if different E-Mail:paradiseexteriorsllc(a,gmail.com
from the Owner listed above) State or County License:SCC131150472
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMEtTAL-�CON5TRl1eTIt7N'LIEN LA111l�INFORMATIO`N *' fr{
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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 holderto 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;screenrooms 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.
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atuof-Owner/-Agent/Lessee — -� --- - Signature-of-Contractor/L-icense-Holder-- - - — ---- — -
STATE OF FLORID STATE OF FLORID
COUNTY OF 1"o IL COUNTY OF '
The forgoing instrument was acknowledged before'me The fgrgping instrum t was acknowledged before me
thistiay of M 20 -1 by this /,t,-day of GL zo by
(Name of person ac nv } Name of person acknowledging}
Notary Public-State of Florida { p
��� •: ;• Commission M GG 010186
My Comm.Expires Noy 6.2020
Of F, Bonded through National Notar Assn.
(Signature of Nota y, (Sig to N ar ub' State of Florida}
Personally Known OR Produced Identification P onally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. �.-
,.�;, 810
Revised 07/15/2014 r
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS