HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d
Date: Permit Number:
-1 J RECEIVED
Building Permit Application JAN 31 2018
Planning and Development Services ,
Building and Code Regulation Division ST. Lucie County, 0@.r iltflt19
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential xxx
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 2880 HARSON WAY Fort Pierce, FL 34946
Legal Description: SAN LUCIE PLAZA S/D-UNIT ONE- BLK 59 SLY 25 FT OF LOT 25 AND ALL OF LOT 26
(MAP 14/29S) (OR 4069-259)
Property Tax ID#: 1428-702-1341-000-1 Lot No.25
Site Plan Name: Block No. 59
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
I 7
� 2 lanl
CONSTRUCTION INFORMATION:
Adcl,iona worl to be ne,lormel under this permit—check all apply:
_ VAC Gas TankF]Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: j Sq. Ft. of First Floor:
Cost of Construction: $ ?- �-1 o Utilities: 0 Sewer I Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Envision 367 LLC Name: KENNETH F.CONWELL
Address: 15001 NW 3rd AVE Company: CONWELL 8 ASSOCIATES CONSULTING COMPANY
City: Miami, FL 33168-4207 State:FL Address: 11771 SW 137TH PLACE
Zip Code: 33168-4207 Fax: City: MIAMI State:FL
Phone No. Zip Code: 33186 Fax: 305-385-7827
E-Mail: Phone No. 305-926-5673
Fill in fee simple Title Holder on next page( if different E-Mail: KCONWELL@CACONSULTINGC.COM
from the Owner listed above) State or County License: CMC1250012
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 3d rJ 1
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: JZNot Applicable MORTGAGE COMPANY: of Applicable
Name:- Name:KFNtiFT F ��NwF
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLEI T� LE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:117z,sw 1a7TE4 21 ACE 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
commencin ork or recording our Notice of Commencem
v �—
Signature CY Owner/ ssee/Contractor as Agent for Owner of Contractor/License Holder
STATE OF FLOR13� _ � STATE OF FLORII)A�
COUNTY OF }�� COUNTY OF j—/r'1YJ
The f rgoing instrument was acknowledg�efore me The fo%oing instru t was acknowledg b fore me
this day of 20� by this i "day of C1--. 20 , by
Al SnrwA
Name of person making statement Name of person making statement
Personally Known___L---'OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identifico,95
Produced Produced 1/'T/
(Signaturelof Notar�r Public-State of Florida ) (Signature of botary Public-State of Florida)
Carolyn M.Comdeli
'' `� ' s.on #0101091 Commission No. o"av'a"
Commission �= + �` '� Carolyn M.Wylf
Expires: October 7, 2020 Commission # GG001091
Bonded thru Aarrn Notary ' Expires: October 7, 2020
Bonded thru Aarcn Notary
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATI N SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17