HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: January 18, 2018 Permit Number: 1 oz, 0
Building Permit Application
JAN 2 3 2018
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 J
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED 1MPRO:VEMENT LOCATION
Address: 211 TRAVIS CAY PL B-12
Legal Description: TROPICAL ISLES (OR 2786-2163) UNIT B-12
Property Tax ID#: 34107508-0030-000-6 Lot No. B-12
Site Plan Name: Block No. 235
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
=±t,'rs+ a ,.j-, r .`r.S4 _ _ sfl m�.� 1�, .�.-'W. •nr KL"µ 3_...= �p ��,fl,^� ,^ys-
Re-Roof existingshingle roof with removingexisting shingles placing with new shingles.
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CONSTR:UCTIO.,NINfORMA�'ION
F.P. n
itiona wor to e e orme under this permit—c ec K all
_ appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric In Plumbing Sprinklers E Generator F,/] Roof 3112 Roof pitch
Total Sq.Ft of Construction: 1100 Sq,Ft.of First Floor: Mobile Home
Cost of Construction:$ 6500.00 Utilities:Sewer[]Septic Building Height: 13
01NN.ER(.LESSEE ,. a1 _ CONTRACTORfia � t� R
Name Pam Vandermark Name: Drake Marston
Address: 211 Travis Cay Place Company: MRC Services/Manta Ray Construction
City: Fort Piece State: Fl Address: 85 South Las Olas Drive
Zip Code: 34982 Fax: City: Jensen Beach State: FI
Phone No. (772)359-7938 Zip Code: 34957 Fax:
E-Mail: Phone No. 772-201-8316
Fill in fee simple Title Holder on next page(if different E-Mail: mreservicesfl@gmail.com
from the Owner listed above) State or County License: CCC 1330490
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION; „ e
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 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,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 or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIQq
COUNTY OF__,94 AjLt.A_Q. COUNTY OF
The forgoing instrument was acknowledged before me The f rg ing instruqwnt was acknowledged before me
thiha.day of 12019 by thay of 2015 by
Sky eyn pY1)ar5+o N Sk\j e-K 1)no)r-c )arsk)tQ
Name of pers n making statement Name of per n making statement
Personally KnownOR Produced Identification Personally Known OR Produced Identification
Type of Identification7 Type of Identification
Produced Produced
Q
(SignaturL%of Nota Pu . (Signature .
CHERYL A HClTTENSMITH CHERYL A HOTTENSMITH
Commission No. �•i MY CCWMQSION#¢0090400 Commissio
EXPIRES Apol 04,2021 ION#X0400
• •. �� EXPIRES April 04,2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17