HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Name:F,w,a,-. ,
Address:%w's.�. Address: ex,sim---ur
City: 'ossium. State:_ City: roes, "• State:_
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:s� A.
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 Countyry makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
Is in
which con0ia with any applicable Home Owners Assonation rules, bylaws pr an covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your Beed 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,
acmuory 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 work or recordin our Notice of Commencement-
signature of owner/ Lessee/contractor as Agent for Owner
r5t0eof ontractor/License Holder
STATE OF FLORIDA
STATE OF FLO" I�
OF
r t---eCOUNTY
COUNTY OF.F
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledge�,,ljefore me
this _day of 20_ by
this t day of uum 20 by
F(zed e e(Ck [T1I��-e,
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
of Identification
Produced
Produced
i
i
(Signature of Notary Public State of Florida I
(Signature of Not@, ublic State of Florida)
Commission No. (Seal)
Commission No (( JI(
- MYC agll347
M ft law Atari
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS VEGETATION SEATURTLE MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34981
Phone; (772)462-1553 Fax:(772)4624578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 8501 S Indian River Drive
Legal Description: Range 41 E Twnship 36S Section 18 Lot 4
Property Tax ID p: 3518-433.0002-00013 Lot No. 4
Site Plan Name: Block No.
Project Name: Davis
Setbacks Front Back: Right Side: Leh Side:
DETAILED DESCRI r
A/C Change out Like for Like \ fare l,0 ' U S [— E (-
3.
CONSTRUCTION INFORMATION:
Additional 70 rK toe e Orme un art ispermif=cher appy:
❑�✓
HVAC Gas Tank Das Piping El Windows/Doors
_Shutters
ll
UIElectric Plumbing Sprinklers Generator E IRoof Roof pxch
Total Sq. Ft of Construction: ScFtFt.� of First Floor:
Cost of Construction:$ $890.00 Utilities: L] Sewer E]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ElanEge Dams
Name: Frenenck Molar
Address: 8501 S Indian Rwer Or
Com an Millers Central Air. Inc.
Company:
V
City: Port St Lucie State:_
Address: 673 SW Carter Awa
Zip Code: 34982 Fax:
City: Port St Lucie State:FL
Phone No. (731) 780-7608
Zip Code: 34983 Fax:
E-Mail: eldrrMege(rggmail.com
Phone No. 772-785-8080
Fill in fee simple Title holder on next page ( if different
E-Mail: Lea�mVllarscentralelr.eom
from the Owner listed above)
State or County license: CAC058675
11 value of construction is $2500 or more, a RECORDED Notice of Commencement is required.