HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date:_ �' �- ' �� Permit Number: 1 V v 515
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Building Permit Application
Planning and Development Services PETT I',I Ci
Building and Code Regulation Division St. Lucia COL!n tX?, FL
2300 Virginia Avenge,Fort Pierce PL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line '(j1
Address: 4245 S INDIAN RIVER DRIVE
Legal Description: 35 35 40 BEG AT PT ON W LI OF E1/2 OF NE 1/4 . 1255.36FT N OF S
LI OF SE 1/4 OF NE1/4
PropertyTaxlDll:_2436-113-0007-000--8 T _ Lot No.
Site Plan Name: BLOEHM Block No,
Project Name: at 0 a �'V'_
Setbacks Front Back: Right Side: Left Side:
,MOK M,0 1W, 110
0111 t .
wt
New- I
Install power to 15 motorized shutters with remote.
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Additlorial wor o e erormed un er t s permit—check a -apply:
HVAC Gas Tank aGas Piping _Shutters Windows/boors
13 Electric 0 Plumbing OSprinkiers 11 Generator �Roof
Total Sq.Ft of Construction: S ,Ft.of First Floor:
Cost of Construction:$ 2450 Utllities:nSewer 11Septic Building Height;
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Name Rosalie Bloehm Name: JAMES P WILLIAMS
Address:4245 S Indian River Drive Company: ARLINGTON ELECTRIC
City: FORT PIERCE State: FL Address; 3251 SE DIXIE HWY
Zip Code; 34982
Fax: City: STUART State: FL
Phone No. 772-461-1656 zip Code: 34997 Fax: 772-287-2380
E-Mail: Phone No.772-287-1353
Fill in fee simple Title Holder on next page(If different E-Maii:greg2@arl:Lngtonelectricinc.com
from the owner listed above) State or County license: ECO0 0 012 7
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 TITLEHOLDER: _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.
S ,Luce Count make no representtation that Is granting a hermit WIII authorize the permit holder to build the subject stkructure
w rich sin on lict wlt�i any pplicabla Home Owners Association rule ,bylaws or and covenants that may re trictor prolliblt such
structure,Pease consult wit�i your Home Owners Association and rev ew your deed for any restrictions whici 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.Lucle 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 yourpproperty,`A Notice of Commencement must be recorded and posted on the jobsite
before the first ipspectlon,if you Intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement,
S
Si atur of Owner/Lessee/Agent Sfgna re of ontractor/License Holder
STATE OF FLORIDA STATE~OF FLORIDA
COUNTY OF MARTIN COUNTY OF MARTIN
The forgoing instrument was acknowledged before me The forgoing Instrument was acknowledged before me
this 2 3day of. AUGUST , 20 17by this' ,day of / - 20 a by
JAMES -IP WILLIAMS JAMES P WILLIAMS
(Name of person acknowledging) (Name of person acknowledging)
(Signa urs ' ry Public-State of Florida) (Signature .Notary Public-State of Florida)
Personally Known i0 0 Pr du ed de tlfication Personally Known �bR Produced Identification
Type of Identification P use of Identlflcatlon Produced
;Pay"mss H ROBINSON
?`+• i -NQ�g��ublic.-State of Flor dG mI5510n No. •`���+!'Y P�6��i �
Commission No, _ ;. Cb�1ii ussion#.GG 03314 ,�:. : Notao u1111t:•Slate of Florida
9,F Pz My Comm.Expires Sep 25,.2 20 ' + = Comm{ssion N GG 033149
Bonded through National Notary Assn: ''.jf c�:- '
Revjsed07/i5/201 !l+t+0� Bonded through NaUonaINotaryAssn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS