HomeMy WebLinkAboutBuilding Permit Application From Team K5 1.407.469.3499 Wed Nov 8 11:31:04 2017 MST Page 1 of 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l�'�' l Permit Number: 7� `O p;2
�U,E IV ELY
_ NOV 0 0 2017
Building Permit Application
PERMITTING
Planning and Development Services St. Lucie County, FL
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1S78 Commercial Residential
i
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOKPIMPROVEMENT LOCATION
Address: 4751 S Indian River Dr.
Legal Description: See attached.
Property Tax I D#: 2436-331-0006-000-4 Lot No.—
Site
o.Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side;
1.,;DETA-ILED DESCRIPTION OF,INORK:`
replace 3 windows size for size /(:—,-,,x S
CONSTRUCTION JNFpRMAT10N. ;
Additional work to be performed under tispermit—check all
thappy:
HVAC Gas Tank ❑Gas Piping LJ Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers FIGenerator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 4214.00 Utilities: Sewer Septic Building Height:
'01NNER%LESSEE:_' CONTRACTOR:
-- -
Name William Curtiss _ Name: Raquel Swanner
Address:4751 S Indian River Dr. Company: The Home Depot
City: Fort Pierce State:FL Address: 6500 NW 12TH Ave. Suite 110
Zip Code: 34982 Fax: City: Fort Lauderdale State:FL
Phone No. Zip Code: 33309 Fax:
E-Mail: Phone No. (754)224-2010
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CGC1514813
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
From Team K5 1.407.469.3499 Wed Nov 8 08:30:56 2017 MST Page 3 of 48
,
SUPPLF MENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: _ Phone: Zip: Phone: j
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 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 an attorney before
comn-renein work orA(;ordjnfNour Notice of Comm. t.
Signatdre f,Q*Jfr/'ge Lessee Signattfre of Contractor/License Holder
STATE/OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF St LuIf"r—
The forg mg instrument was acknowledged before The forgoing instrument was acknowledged before me
me this day of 0-JO-J 20 17 Uy this S day of /14*✓ 20j7 by
1 12g d,,v.A-1 120-1"44 SC"50%hr,A./—
(Name of person acknowledging) (Name of person acknowledging) ,
rvTcrts.':aanveeLrA't?_-'ra:Rbsa+ .A'.Cu^.., cnceu�c.1cacMx,.��+—
(WU � � TIt,A&TM R,O' _LEY
o¢d.. TIMOTHY R.O'IAAI EY l =:n1 .;c:%
COh4M!SSION#UG 117135 �� MY COMMISSION# 311713
FXPIRE
2021
(Signature of Notary Public-Stat f 0d)Bonded7hru Holary Public 14.
oli$!I re of Notary Public-State of FI Bonded ll rurlolayPuo underr+r+!
-Ail D
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 66 It-71-55 (Seal) Commission No.66 11-713 5 (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
� O � L