HomeMy WebLinkAboutBuilding Permit Application " ALL'APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED + /�
Date: Permit Number: 04YE
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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
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT+LOCATION:
Address: 5861 TRAVELERS WAY
Legal Description: PALM GROVE S/D BLK C LOT 7 (0.13AC) (OR 1462-2183)
Property Tax ID#: 3410-503-0075-000-8 Lot No.7
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION 'OF_WORK:'
ccic-fi (A) t( G c,��P ou-t -40J!�T_
C NSTRUCTIGWINFORMATIOW .
Additional work toe e orme under this permit—check a appy:
HVAC E] Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric ✓❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 500 UtilitiesSewer 0 Septic Building Height:
OWNER/LESSEE', `, CONTRACTOR,
Name Morgese Michael & Carol Name: ALLEN STEINMAN
Address:5861 Travelers Way Company: SERVICE AMERICA
City: Fort Pierce State:FL Address: 2755 NW 63RD CT
Zip Code: 34982 Fax: City: FT. LAUDERDALE State:FL
Phone No.772-465-9162 Zip Code: 33309 Fax: 954-977-3591
E-Mail:car2@comcast.net Phone No. 954-979-1100
Fill in fee simple Title Holder on next page(if different E-Mail: epermitsgroup@servicesmerica.com
from the Owner listed above) State or County License: CFC057i 026
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SU'P.PLEMENTAL CONSTRUCTION 'LIEN LAW INFORMATION w y'
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 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
commencing work or recording our Notice of Commenceme
s
Signa ur of caner/Lessee/Contractor as Agent for Owner Sign re Contractor/License Holder
STATE OF FLA A STATE OF FLOC
COUNTY OF roc�cir COUNTY OF `r—>✓DEQ -7
The forMng instruTent was ack owledged before me The forgoing instryfrtent was aFknowledged before me
this I^7 'aay of rTL4 c.I67 20 �w7 by this �Wday of �U U 20 17 by
Ier 1,3 M n ct✓�
(Name f person ac owledging (Name person a nowled ' )
(Sign re of otary P lic- ate of Florida) (Signat re of Not �/ blic- tate of Florida)
Personally nown X ce en i ica ion Personally Known /�
R. ,e Sheneka Hardy Type of Identification Pro u d""f P�
Type of Identification r � YP � caHar�y--
_ 0 Notary Public- tateo on a
�r. c 2 � � Notary Public-State of Florida
Commission No. Co r9!3`g)on#GG 33870 Commission No. C'A0A16on#GG 33870
Expires 9/27/2020 115 F`o�J Expires 9/27/2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS