HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 Permit Nu btT-- Rim MIMI
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Building Permit Application AUG 01 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 5t. Lucie County, FL.
Phone: (772)462-1553 Fax: (772)462-1578 Commercial 'Fd
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION..
Address: 221 Olive Ave, Port St Lucie, FL 34952
Legal Description: RIVER,PARK-UNIT 2-BLK 19 LOT 46(MAP 34/22S) (OR 3591-556)
Property Tax ID#: 3419-510-0277-000-3 Lot No.46
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK::
Replace garage door
CONSTRUCTION INFORMATION
Additional work to be performed under t ispermit—check all appy:
11HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric ❑Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 1500.00 Utilities: Sewer O Septic Building Height:
O,W
NERACTOR:ft/LESSEE:: CO.CON _
Name Todd Welsh Name:
Address:221 Olive Ave Company:
City: Port St Lucie State:FL Address:
Zip Code: 34952 Fax: City: State:
Phone No.561-512-9330 Zip Code: Fax:
E-Mail:doltran@bellsouth.net Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: 4
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:Toad welsh Name:
Address: Address: 221 Olive Ave
City: PortSt Lucie State: FL 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 Co ent must be recorded and posted on the jobsite
before the first inspection. If you intend to obt 01""c
g, consult with lender or an attorney before
commencin work or recordin our Notice ofment.
A
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Signature of Owner/Lessee/Cont rac r as Agent for 0 r56o ignature of Contractor/License Holder
2 M�
STATE OF FLORID _ � TATE OF FLORIDA
COUNTY OFz OUNTY OF
25.s
C�T
The forgoing igWmVent was acknowledgedt9fore mea oA he forgoing instrument was acknowledged before me
this I day o 20 o by " is day of 20_ by
-ro 1 s 7il
Name of person making statement Name of person making statement
Personal) Known OR Produced Identification Personally Known OR Produced Identification
Type of Idication Type of Identification
Produced r Produced
aC4 YL4 5.
(Signature of Otary Public-State of Florida (Signature of Notary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17