HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED e ,
Date: November 5,20188 Permit Numbe
EVE-LOCIVED
• NOV 15 2018
Building Permit Applicati®n
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
.2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Demolition
PROPOSED IMPROt/ENiEN9 I. CAIIuN
Address: 3940 Orange Avenue, Ft. Pierce, Florida 34947
Legal Description:All of that part of the SW 1/4 of the N.W. 1/4 lying south of the north.St. Lucie River
Drainable district canal and north of the right of way for Orange Ave. extension.
Property Tax ID#: 2408-233-0004-000-2 Lot No.
Site Plan Name: Block.No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DESCRIPTI01��'OF WORK
Dt�TA1LE. - _
Demo complete building.
CNSTfUCTION INFORMATION {
Additional wor to be nerformed under this permit—cheCK all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers E]Generator Lam.Roof Roof pitch
Total Sq. Ft of Construction:: l e O 0 Sa. Ft.of First Floor:
Cost of Construction:$ /� Utilities: Sewer U Septic Building Height:
QINNER%LESS'EE
�d NT'RACTOR .
Name Dorothy Jarvis Name: Terrance Mottley
Address: 144 Greenwood Drive Company: T H Mottley Construction, Inc
City: West Palm Beach State: FL Address: 378 Northlake Blvd., Suite#266
Zip Code: 33405 Fax: City: North Palm Beach State:FL
Phone No. (561)358-4359 Zip Code: 33406 Fax: (561) 843-1403
E-Mail:
Phone No.
(561)502-1986
Fill in fee simple Title Holder on next page(if different E-Mail: mottleyt@aol.com
from the Owner listed above) State or County License: CGC058855
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEtV1 NTA CONSTRUCTION LIEN LAW INFORMATION:
PE*GNER/EiNGiNEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone . Zip: Phone:
FEE SIMPLi TITLE HOLDER: M Not Applicable 13CRIDING COMPANY: Not Applicable
Name: (Name:
Address: Address:
City: City:
Zip: Phone: Zip: _ Phone:
OWNtR/CAON' RAC OR IAFFIDViT: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 whlch may apply.
In consideration of the granting of this requested permit,1,do hereby agree that 1 will,in all respects,perrnrm' the work
In accordance with the approved plans,the.Fiorida 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:Irl yoesr paying tike for
improvements to your property.A Notice of Commencement must be recorded and posited on the jobsite
before the first inspection.If you intend to obtain financing,consult wlth.lender or an attorney before
commencin. Worl<.or recordingypur Notice of Commie nt.
daA
Signa ure of Owner Les /Contractor as Agent for Owner Signature of Contractor/Licen older
rSTATE-OF FLORIDA Palm Beach STATE,OF FLORIDA palm Beac
COUNTY OF COUNTY OF
i
The for oIng instrument was acknowledged before me The forgoing instrument was acknowledged before.me
this 5th day of November 20 ig by this 5th day of November .20_j_& by
Dorothy Jarvis Terrance Mottley t
Name of perp making statement:.. Name of persa making statement
Personally Known OR Produced Identification Personally Known P' OR Produced identification
Type of identification Type of Identification
ProducecL
�j Produced
tit
(Si ture - "�iorlda ` • ? P••. �:'.
rida)
�n'�'p ER 14
Commiswri1XV� ER 1 (seal) commioor0
(Seal)
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is ; p55216
REVIEW F 4S SUPERVISOR LE MANGROVE
d ` ` REVIEW REVIEW �ic�oa•' W REVIEW
R CEIVFD //rpUBLIC,SIN �\ ,/�IiC'V
DATE IIUt
COMPLETED
Rev.$/2/17