HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 14' ��� Permit Number:.
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: Shed DCA
'TRACTOR a k
Name Marilyn Minix
Name: (i["Il2 �✓! llI Gds
OCATION
PROPOSEQ IIVIPR011EMENT LOCATION'S
i
City: Fort Pierce State: Fl.
Zip Code: 34946 Fax: 772-464-0987
Phone No.772-464-0969
E-Mail:sean@roadrunnertraveiresort.comPhone
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Address: 5500 Saint Lucie Blvd.
Legal Description: 30 34S 40E 30 34 40 SW 1/4 OF SW 1/4 LESS A STRIP OF LAND
& 333 FT ON S LI (OR 322-2003)
Property Tax ID #: 1430-331-0002-000/5
Site Plan Name: Road Runner
Project Name:
Setbacks Front Back: Right Side: Left Side: _V
Installgfoot X 8 foot shed DCA
E BEING 331.2 FT ON N LI
Lot No._,
Block No.
Additional worK to lie nertormed under this permit— cnecK all apply: . I C
HVAC Gas Tank E]Gas Piping _ Shutters D Windows/Doors
❑ Electric ❑ Plumbing Sprinklers 1:1 Generator FF] Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ ��0 v Utilities: _ Sewer []Septic Building Height:
OWNER `
'TRACTOR a k
Name Marilyn Minix
Name: (i["Il2 �✓! llI Gds
Address: 5500 Saint Lucie Blvd.
Company:
Address: 3 3 ( Svc 1 S P
City: State: %�
Zip Code: I Fax: 16P X`; G 7
No. 2-0(1 P 3 7Y
City: Fort Pierce State: Fl.
Zip Code: 34946 Fax: 772-464-0987
Phone No.772-464-0969
E-Mail:sean@roadrunnertraveiresort.comPhone
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: JI, ;�.L� y /�/fi 33 / -�by',, A"o 'e—ca.,
i
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN,INFORMATION "
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
MANGROVE
Name:
_
Address:
REVIEW
Address:
City:
State:
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address:
Address:
INITIALS
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 thepermit 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
L.UIIIIIICIILIIIF wuf I( Uf IUuuIUIIIk VUUI INULII.0 UI I..UIIIIIIUIIL.CIIICIIL.
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 57 y c l te COUNTY OF ;57 Lug f
The fqo,rgGoing instrument was acknowledged before me
this/ day of u V) le , 20 13y
1
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
(Seal)
The forgoing instrument was acknowledged before me
this // "{ day of � (vl %e 20 L by
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS