HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEDI l W V
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Date: Permit Number:
_ = RECEIVED
Building Permit Application FEB 05 2018
Planning and Development Services
Building and Code Regulation Division �T� LUCIA County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial xxx Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 5500 Saint Lucie Blvd. Fort Pierce, Florida 34946
Legal Description: 30 34S 40E 30 34 40 SW 1/4 of SW 1/4-Less a strip of land on a Being 331.2 Feet
on N LI &333 Feet on S LI (or 322-2003)
Property Tax ID#: 1430-331-0002-000/5 Lot No.�
Site Plan Name: Road Runner Travel Resort Block No.
Project Name: w.OA'
Setbacks Front_ Back: r Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additionalwork to be nertormed under this permit—check a app y:
HVAC Gas Tank Gas Piping Shutters ❑Windows/Doors
❑Electric ❑_Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: I Sq. Ft. of First Floor:
2,1&z52,1&z57.Cost of Construction:$ , . do Utilities:Sewer 0Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Marilyn Minix Name: Lori Williams
Address: 5500 Saint Lucie Blvd. „-(�� Company: D & M Concrete Constuction Inc.
City: Fort Pierce State: F1 Address: 331 Sunrise Dr.
Zip Code: 34946 Fax: (772) 464-0987 City: Fort Pierce State: FL
Phone No. (772) 464-0969 Zip Code: 34945 Fax: —7
E-Mail: sean@roadrunnertravelresort.com Phone No. (772) 465-4355
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: #24764
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Ap _ 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 l 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 Halder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5� L-0Z r -e - COUNTY OF S�• LU LI�-
The fo�oing Instrum t v4as acknowiedgg efore me The forgoing Instru ntWas acknowledged-before me
this day of d 20_ by this day of fi=b by
(Name of person acknowledging) (Name of person acknowledging)
"H �n
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of identification G DRII►1NDY
Produced 'Produced KARYN
N(3 DRAWDY ' - MY COMMISSION#FF198fi5a
Commission No.vv Commission No. ~� P �nwry f1.201Q
fw :•T MY COMM, SIOtd tt FE 79855 Nc7,�e o�s3 Flaa�nsw w cwr
No PIRES Feor"'t i 1,20/8 �-
153 aw. N;cn.wc
REVIEWS FRONTSUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. R CEIVED
Lr-T' -�+cie County, Permlttlnp