HomeMy WebLinkAboutAppALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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 Residential X
PERMIT APPLICATION FOR: Window/door
.IRPPOSED IMPROVEMENT LOCA=TION,:
Address: 12951 S INdian River Drive, Port St Lucie, FL 34957
Legal Description: 4 37 41 N 190 ft of fol desc prop; beg 60 ft s of pt on w bankind rvr. sd pt being 335 7/12 ft n of s bdry of sec
th run swly to e r/w fec rr. th nwly alg r/w 350 ft m/I th nely to riv th sely meanering riv 350 ft ml to pb-less sr 707
Property Tax ID #: 4504-340-0006-000-6
Site Plan Name:
Project Name: Jack Miller
Setbacks Front Back:
Right Side: Left Side:
Replace 5 impact glass windows size for size
Lot N o._
Block No.
Additional work to be ertormeci under tnis permit — F_1cnecK aii nat apply:
HVAC _ Gas Tank []Gas Piping Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers 11 Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: 2628 SFt. of First Floor: 1641
Cost of Construction: $ 5502 Utilities:._ Sewer _ Septic Building Height: 13
Name Jack Miller
Address: 12951 S Indian River Drive
City: Jensen Beach State: FL
Zip Code. 34957 Fax:
Phone No. 772-530-2009
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Michael O'Donnell
Company: O'Donnell Contracting
Address. 6402 SE Federal Hwy
City: Stuart State: FL
Zip Code: 34997 Fax: 888-833-0164
Phone No. 772-408-0200
E -Mail: rcdonne11311 @gmail.com
State or County License: CRC1331273
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:
SIMPLE TITLE HOLDER: Nof Applicable
BONDING COMPANY: Not Applicable
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Name,ress:
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Address:
:City:
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 consultwith 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 Commencement,
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_ Signature of 0 er/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA 5 C
COUNTY OF 1 �v CI `e_ COUNTY OF.
Thi orgoing instrument was acknowledged before me Thef going instrument was acknowledged before me
this Y
da of ® 0 T— , 20 l2.by this day of OC �— , 2D / I by
M IG t4-&ry C Q' bdNNI-e /U( l(Hr-�-DO N�-f I l
(Name of person acknowledging ) (Na me f person ackno ledging
(Signature of Notary Public- State of Florida) (Sig lure of Notary Public- State of Florida )
Personally Known OR Produced Identification _ Personally Known OR Produced identification
Type of Identification Type of Identification Produced
__ I hY �l ISSIONFFos�55c� Commission No, �� '' : (Seal�`.ALE FULLER
Commission No. 1' � � •�� �•I;
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EXPIRES October 20, 2017 �c.,, '. MY COP�IMISSION •RF•F06 -8
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Rnrised 07/1S/201.4
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
D A7E
COMPLETE
INITIALS