HomeMy WebLinkAboutBuilding Permit Application 01/06/2018 SAT 10: 04 FAX 7722933274 0002/003
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:—I- L.�— Permit Number: O 1 LJ
RECEIVES
Building Permit Application ,JAN 0 8
Planning and Development Services "
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)452-1578 Commercial Residential xxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end
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Address: 1106 Kingswood Ln
Legal Description: Driftwood Manor-Sec tow Lot 5
Property Tax ID#: 3404-807-0005-0001 Lot No. 5
Site Plan Name: Block No.
Project Name: William Haines
Setbacks Front Back: Right Side: Left Side:
MIS tvi �I
Change out 40 Gallon Elec Water Heater
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ona wor towel under this perm) —check a apply:
�FIVAC Gas Tank 17]Gas Piping _Shutters ❑Wlndows/Doors
Electrlc Plumbing Sprinklers 11 Generator L1 Roof Roof pitch
Total Sq. Ft of Construction: 5Ft.of First Floor:
Cost of Construction:$ ,2 •n(� utllltles:]Sewer ElSeptic Building Height:
RIMINI
Name William HainesNdm@: Robert Sarron
Address: 1106 Kingswood1ane „ , . Lindstr�omom any
City: White City State: Fl Address: 3581 W McNab Rd
Zip Code: 34982 Fax: City: Pompano Beach State: FI
Phone No. 772-484-0476 Zip Code: 33069 Fax:
E-Mail: Phone No. 772-600-4088
Fill In fee simple Title Holder on next page(If different E-Mail: dulcem@lindstromair.com
from the Owner listed above) State or County License: CAG1427611
If value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
01/06/2018 SAT 10: 04 FAX 7722933274 E003/003
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name•"I'am Habwi Name: Rna•rl Barton
Address: 1118 klno'-°°d Ln Address: 1106 Kngc-00 Lana
City; wit Lecity State: City: Pompano®each State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: "Not Applicable BONDING COMPANY: _Not Applicable
Name; Name:
Address: 3501 W MONebRd Address:
City: City:
Zip: Phone: Zip: Phone;
OWNER/CONTRACTOR AFFIDVIT:Application Is hereby made to obtain a permit to do the work and installation as Indicated,
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,bylawsGr 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 addltlons,
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 recordina your Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 54 �G��l' COUNTY OF Zk 4jA r,�C
The foIr�,Ging Instrument was acknowledged before me The forgoing instru5ent was afknowledged before me
this 2 day of QIe e ,6n k,-• ,20_ by this�day of (.�M `�-i 2Q4� by
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Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known mac_OR Produced dentification
Type Identification Type of Identification
Pro c d Produc _
( 'gnature of Notar DOR Statp ppip�l�&Z
is
atur o of r ubllc-Stat of FI da
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Oamml9.lonN PpfQQ��3381
Commission No. ' plreeMayt X0'11 CommIssf ,.... commbdon#G0103391 (Seal)
'��„ i° BOnOaAINuBW�dlHoury9ar.k.a � DULCE MARTINEZ
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
FATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17