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HomeMy WebLinkAboutBuilding Permit Application I� I +I ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 1 0*1, Q— Q I , A ann ing�:nd.Development Services j Building and Code Regulation Division 23"00 Virginia Avenue,Fort Pierce FL 34982 � Phone: (772)462-1553 Fax: (772)462-5578 Commercial j Resit(en6al_X r PER-MiT A-PP-LiCAT10N FC 'R: To Select from dropbox, click arrow at the elld of lino s PROPOSED IMPROVEMENT LOCATION: i! Address:_3116 NW Radcliffe Way Palm City,Pt.34990 I, Legal Description: Riverberid (.PB 67-361 Lot#23 Parcel#442.5-703-0028-000-7 Property Tax i,D#: � � Lot i No. Site Plan Marne: I ' Block No, Project Name: Setbacks DETAILED DESCRIPTION OF WORK: "Location Pemit" for Custom built Chichee Hut with Thatched Roof CCONSTRUCTION INFORMATION: Wdi-fional work to be i3ertormed lin er this permit-cnecK� affsil-- lipply: i i.I WindswsjDoorsi0.H ( Gas Tank ! Gas Piping OElectric Plumbing .Sprinklers ( `Generator Roof Roof pitch I Total Sq. Ft of Construction: 180 Sq. Ft-or First Floor l Cost of Construction:$ 2300.01 Utilities: Sewer EDSeptic i Building Height: CONTRACTOR•, OWNER/LESSEE. ___....._ _._. ) _ _. _...._.__.._.._.............................__. • `i Name Pete Stan`Harlesveidt Name: Olive Scot t McCauley i Address: 32's i'N !r3adcliffe may Company: Bi f:aft"una Tiki Huts;Inc. _......................._...... _. City: Palm City State: FL Address: 601 IvIonroe Av;c�noe Zip Code: 34990 Fa City: Cape Canaveral 1 i State: FL Phone No. 571-237-47,67 Zip Code: 32 20 j f Pax: ! !! -Siail: P vanhart=a aal.c©m p{�grie No 877-2,49-4038 E l I Fill in fee simple Title Holder on next page(if different E-Mail: palmhuts@yahaa.com 'CBC1259971 from the Owner Rsted above} I State or Courvt4l License:_ _ If value of construction is$2500 or more,a RECQRDED Notice of Commencement is required,y — I , I � d �, i I SI�PPL'EMEIUTA�.G�NSTR�[CTl0 L1Ef =LAIN 1NRaR.lVlATION, ,� e� r. .... .. ...F,.. .,,..>. _ _ .� .. ..i,'_l vz rub _�:` t ,._ia..e--e:._._�_.__..=:�x... • ... .,. , ..... DESIGNER/ENGINEER. — Not Applicable MORTGAGE COMPANY: i` Not Applicable Name: Name: i Address: Address: I I City: State: City: I i' State: Zip: Phone ' Zip: Phone- I FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: I Not Applicable Name: ' Name Address: Address: City: City: Zip: Phone: Zip_ Phone: I OWNER CONTRACTOR AFFIDVIT:R licatiowis hereby made to obtain a f PP Y permit to do the work and is�sta{lation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. I St.Lucie Count{makes no representation that is granting,a permit will authorize the perp itt holden to build the subject structure which is in conflict with any applicable Horne Owners Association rules,bylaws Oran covenants that rrmaq restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for a6y 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,reviewl•room additions, accessory structures,swimming pools,fences,walls,signs,screen roams and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Commencement may resultJn your paying twice for improvements to your property.A Notice of Commencement must be recorded a'nd 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 Qf CorpMencement. _ I R I J1W1,41 M1 .... AA0- II V Signature of Owner/L see/Contract r as Agent for Own_Y, j Signa ure of r-ontrart6r/License Contractor/LicenseHolder 3 ! STATE OF FLORIDA STATE OF FLORI�A (j COUNTY OF r t r r i COUNTY OF r9 r" The forgoing instru ent tivas acknowledged before me i The forgoing instrument�nt was acknowledged before me thisdayofzoo bV )) r this `�tb day of tt. i. /�.20�} by V-e r-- SCo- Al C Gt.. L�� f 0/i re r' � ed Pi X-C �oG-psrson making statement -- — idamc�af c�erson making statement ersonally Known OR Produced Identification Personally Known '! OR;'Produced identification _ yFre n } crit rcat:ic,r� entirication i Produced Produced ;