HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Septemberl"Ieta //9. di
Permit Nurrbjer—IF0
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Building Permit Applicatio ri SEP 10 2018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 C�
Phone:(772)462-1553 Fax: (772)462-1578 Commercial X L"it, Lgie County, FL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 10350 South Ocean Drive, Jensen Beach, Florida 34957
Legal Description: 11 37 41 S 296.35 FT OF N 901.58FT LYG E OF A1A-LESS S 50 FT OF N 100 FT OF E 300 FT
BEING A PART OF GOVT LOT 1 AS IN DBK 171-381 (3.58 AC) ( OR 414-1408: 515-2796, 2797)
Property Tax ID#: 4511-110-0003-000-0 Lot No.
Site Plan Name: Waveland Beach Park Block No.
Project Name: Waveland Beach Park
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Complete demolition of bathroom facility A/ 0 �Lct e-C$ t—
CONSTRUCTION INFORMATION:
Additional work tobe nertormed under this permit–check all apply:
11HVAC 0 Gas Tank DGas Piping Shutters Windows/Doors
11 Electric ElPlumbing FISprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: ' S Ft of First Floor:
Cost of Construction:$ Utilities'12 Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Saint Lucie County Name: C.G.Taylor
Address:2300 Virginia Avenue Company: L.E.B. Demolition &Consulting Contractors, h
City: Fort Pierce State:FL Address: 7 Harbour Isle Drive East 204
Zip Code: 34982 Fax:772 City: Fort Pierce State:FL
Phone No.772-462-1944 Zip Code: 34949 Fax: 772-461-2225
E-Mail: DurefteM@stiucieco.org Phone No. 772-461-4545
Fill in fee simple Title Holder on next page if different E-Mail: iwreckn@aol.com
from the Owner listed above) State or County License: CGC1 519945/27215
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: 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 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 inWhjd to obtain financing, consult with lender or an attorney before
commencing work or re—cqrding ydurAot.ice of Commencement.
Signature of Owner/Lessee/Contract Agent for Owner Signature of Con actor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFSAINT LUCIE COUNTY OF SAINT LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 7TH day of SEPTEMBER ,20_ by this 7TH day of SEPTEMBER 20_ by
C.G.TAYLOR C.G.TAYLOR
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification N/A Personally Known X OR Produced Identification NIA
Type of Identification Type of Identification
Produce N/A Produced NIA
11111///11/
(Signature of Notary Public-Stat s ,ts f' O% (Signature of Notary kState
Commission No. GG 083308 = (S�e ? Commission No. GG 083308 �,k (SeW)
#GG 083308 y y #GG 083308
REVIEWS FRONT ZOe��� �OR PLANS VEGETATION SEATU�rj� l/C.S��E
COUNTER REVIE�1i0h1/c, 1111 RV's W REVIEW REVIEW REVIEW 01/1/1 III W
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17