HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: k6 b Permit Number:1�
Building Permit Application RECEIVED
Planning and Development Services O C T 2 5 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residen la x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
P.ROP,OSED, IMPROVEMENT LOCATION:
Address: 12271 Golden Eagle St. , Port St. Lucie,. FL 34987
Legal Description: Treasure Coast Airpark Lot 11 (2.33 AC) (OR 2035-319)
Sec/Town/Range: 24/37S/38E
Property Tax ID#: 4224-501-0011-000-8 Lot No. 11
Site Plan Name: None, Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED'DESCR1'_PTION JOF WORK:
Remove sod — Add 237SF 'of concrete sidewalks & 2634SF'of concrete driveway and apron
i P(
".,v.C'P'J e
3600 �S ;
'CONSTRQCTLO;N LN:FORMATION-
Additional
ON:A itiona work to"be nertormed un er this permit-c ec a appy:
HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 28.715- = S Ft,.of First Floor:
Cost of Construction-,$ 15,000.00 Utilities:n Sewer 0Septic Building Height.
QWNER/LESSE`E CONTRACTOR;
_.
Name Gregory T Davis Name: Ronald H Foulks
Address: 12271 Golden Eagle St. Company: RF Concrete Construction, Inc.
City: .Port St-- Llic;P State: FT. Address:- 664 ni i n;X;P 1Lw:V
Zip Code:- 34987 Fax: 772-461-5406 City: Vero Beach State:FL
Phone No. 954-647-6466 Zip Code: 32962 Fax: 772-778-2142
E-Mail: Phone No. 772-567-3356
Fill in fee simple Title Holder on next page(if different E-Mail: ron@rfcconstruction.com
from the Owner listed above) State or County License: CGCO27900/10237
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
_ - -._ ,tea. _._ _ .,. _.__. -. .._- _ r r,..... ,. _•,_
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _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 thepermit 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, consul •th lender or an attorney before
commencing work or recording our Notice of Commencement.
Signa re of wn Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA t STATE OF FLORIDA
COUNTY OF ,-X• U2'/e', COUNTY OF Indian River
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this.,2r dd�ay of oP!X 'eMh'c 20�eby this 18 day of September 20 18 by
UO/ Ronald H Foulks
Name of person aking statement Name of person making statement
Personally Known y OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Tanya Grothe
(SignatLVe of Notary Pub - tr; f iGomr $ion#GG049693 (S' ature r
otary Public-State of Florida)
"= Expires: Nov. 21, 2020 GG145449 s�,,a�1 NANCYCORco
Commission No.�GU Bont�A Aaron Notary Commission No. =?° E"�M'(COMMISSION#GG14!'1109
=a• ,j, EXPIRES:November 4,2 1
'jFOF F,OPS Bonded Thru Notary Public Un lei
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17