HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED y ct
Date: 4/30/18 Permit Number:
RECEIVED
Building Permit Application APR 3 0 2018
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: LDncre1e- �
PROPOSED IMPROVEMENT LOCATION:
Address: 7301 Santa Barbara Dr. Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 1- BLK 4 LOT 14 (MAP 13/14N) (OR 3800-970)
Property Tax ID#: 1301-601-0045-000-9 Lot No. 14
Site Plan Name: Block No. 4
Project Name: Miller Shed Relocation
Setbacks Front 25' Back: Right Side: Left Side: _
DETAILED DESCRIPTION OF WORK:
Move existing 12 x 12 shed to locations indicated on site plan, 17'south.
CONSTRUCTION INFORMATION:
daft onaTworkto be performed under tFis permit—check ziff 1HTappTy:
OHVAC L�J Gas Tank aGas Piping 0 Shutters a Windows/Doors
11 Electric Plumbing Sprinklers O Generator FIRnnf �� Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction.$ $2,508.00 Utilities:n Sewer a Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Joseph Miller Name: Dave "Harley"Van Ginhoven
Address:7301 Santa Barbara Dr. Company: D C Construction $ Company, Inc.
City: Fort Pierce State:FL Address: 1916 21 st Ave.
Zip Code: 34951 Fax: City: Vero Beach State: FL
Phone No.(772) 971-2188 Zip Code: 32960 Fax: (772) 360-8571
E-Mail:jmwoodcarver@aol.com Phone No. (772)360-8571
Fill in fee simple Title Holder on next page(if different E-Mail: harley@ibuildwithcare.net
from the Owner listed above) State or County License: CGC1507W
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Joseph Miller Name:Dave"Harley"Van Ginhoven
Address:7301 Santa Barbara Dr.Fort Pierce,FL 34951 Address: 7301 Santa Barbara Dr.
City: Fort Pierce State: City: Vero Beach State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:1916 21st Ave. 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.
L ed
signature of Owner/Lesse / ntractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDASTATE OF FLOR�DA/ U
/2f
COUNTY OF yYY,t��Li� i � COUNTYOF _
The forgoing instryment las acknowledge efore me The forgoing instrument was acknowledged before me
thi day of 20Vby this3 U day of � 20 r'8 by
Joseph Miller David Van Ginhoven
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification - n Type of Identification
Produced Ft- ��!(,� �i (Q�� Produced
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(Signature of Notary Public-State of Florida (Signature of Notary Public-State of Florida ) TIMOTHY ALLEN B KS
Commission No.
ALEXANDRAPEARSAUL C mission No.r��J��tT a OTARYPUBLIC
Nctary Public-Stated Florid
-- ATE OF FLORID
t Commission a GG 148547 r Comm#FF158M
ti;r r r: My comm.Expires Oct 4.202 s��c�t4�� fres 9/8/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17