HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLIC BLE INVO MUST BE COMPLETED FOR APPLICATION TO BE ACCT PTED
Date: Permit Number:
Building Perm.it 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 XXX �i Residential
PERMIT APPLICATION FOR: Concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 5500 Saint Lucie Blvd. Fort Pierce, Florida 34946 [C—
Legal Description: 30 34S 40E 30 34 40 Beg at SE Cor SW 1/4 of SW 1
333 Feet, Th N to PT on Li of SW 1/4 of SW 1/4 331.2 -feet W of NE Cc
Property Tax ID #: 1430-331-0001-000/8
Site Plan Name: Road Runner Travel Resort
Project Name:
Setbacks Front Back: Right Side: Le
Run W'oip S Ii of SD SW 1/4 of SW 1/4
)f SW 1/4lContinued on Tax.Roll
Side: '
DETAILED DESCRIPTION OF WORK:
/ �1 3 c�� a/-
/
Lot No. f�
Block No.
CONSTRUCTION INFORMATION:
rC f�
A dditiona work to be performed under t isE]GasTank permit — c ec a app y:j,l r
HVAC Gas Piping _ ShuttJrs a Windows/Doors L
Electric ❑_ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: -�'� S S . Ft. of Firs III
Cost of Construction: $ 117 5' Utilities: _ Sewer
Septic Building Height:
OWNERAESSEE:
CONTRACTOR: I€.
Name Marilyn Minix
Name: Lori Williams
Address: 5500 Saint Lucie Blvd.
Company: DII&
M Concrete Constuctibn Inc.
City: Fort Pierce State: FIAddress:
Zip Code: 34946 Fax: (772) 464-0987
Phone No. (772) 464-0969
331 Sunrise Dr.
City: Fort Pierce I State: FL
Zip Code: 34945 1 Fax:
Phone No. (772) 465-4355
E -Mail: sean@roadrunnertraveiresort.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: III
State or Couty
License #24764
If value of construction is $2500 or more, a RECORDED Notice of Commencement, is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Address:
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 vour Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA S�/�
COUNTY OF
The forgoing instrument was acknowledged before me
this Lday of U61020/9by
(Name of person acknowledging )
V5 R LM
(Signature bf Notary Public- State of Florida )
Personally Known ✓OR Produced Identification
Type of Identification Produced
Commission No. /'�a 3Ik%d �?O;." 15eAYNTHTA RAKET
MY CONI MSSION # FF2318
E\TRU S: June 29, 2019
Revised 07/15/2014
s
Signature of Contractor/License Holder
STATE OF FLORIDA ST I-etwL
COUNTY OF
The forgoing instrument was acknowledged before me
this 3Uday of 6 U f-% 20 G'7 by
La ! A/(
(Name of person acknowledging )
'6 4_ ..e��-/
(Signature ot Notary Public -State of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced
mission No. Cj" d 3 1S/0
�, �4OBAKER
coisN F
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS