HomeMy WebLinkAboutBuilding PermitALL 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
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 1s15 5 INDIAN RIVER DR
Legal Description: ENQUIST S/D LOT 3 (OR 3592-2740)
Property Tax ID #: 3507-702-0003-000-1
Site Plan Name: Indian River
Project Name: Dixon
Setbacks Front Back: Right Side: Left Side:
[DETAILED DESCRIPTION OF WORK:
Change out burnt meter can per FPL
NSTRUCTION INFORMATION':
Aciaitional work toe e Orme
HVAC 13 Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction: 4498
Cost of Construction: $ 1200
under t is permit – c ec a app y:
❑Gas PipingMGenerator Shutters
Sprinklers
S Ft. of First Floor:
Utilities:0Sewer 0Septic
Lot No. 3
Block No.
QWindows/Doors
1-1 Roof Roof pitch
Building Height:
OWNERAESSEE:
CONTRACTOR;
Name Stephen & Nancy Dixon
Address: 7315 S Indian River DR
City: Fort Pierce State:FL
Zip Code: 34982 Fax:
Phone No.
Name: Donald B Green
Company: Don Green Electric LLC
Address: 1305 W 1st Street
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-418-5739
E -Mail: dongreenelectric@gmail.com
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: EC13007447
.%a. %Aww I.anwc WI wmmencement is requires.
SUPPLEMENTAL CONSTRUCTION LIEN {AW INFORMATION:
MORTGAGE COMPANY: _ Not Applicable
DESIGNER/ENGINEER: x— Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: Fart P State:
Zip: Phone:
BONDING COMPANY: Not Applicable
FEE SIMPLE TITLE HOLDER: _ 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 voij intPnri to nktnin ...:ate
, wlIaUIL wIui ICfluef Or an attorney Detore
commencing work or recordin our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signattfre of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF MARTIN COUNTY OF- MARTIN
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 18th day of October 20 b
_. y this 18tH day of October . 20_ by
DONALD B GREEN DONALD B GREEN
Name of person making statement Name of person making statement
Personally Known x OR Produced Iden cation Personally Known x OR Produced Identification
T e of Identification Type of Identification
P duc Pro ed
(S at re of Notary Public- Sta a of Florida) (Signa o Notary Public- State of Flori a )
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE
COMPLETED
tev. 8/2/17