HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �'� /'�. t 9 0
Date: Dece ) • Permit Nu
KE E E D
Building Permit Application DEC 14 2018
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 Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line p�_)t°in eq
PROPOSED IMPROVEMENT LOCATION:
Address: 1862 West Midway Road, Fort Pierce, Florida 34982
Legal Description: WHITE CITY S/D 04 36 LOT 60-LESS W 700 FT AND LESS N 105 FTAND LESS TRACT 205 FT X 300 FT IN SE COR OF PARCEL AND
LESS RD R/WAS IN OR 236-673 AND LESS ADDL RD R/W AS IN OR 3831-2844-(1.89 AC-82,189 SF)(MAP34/04N)(OR 3105-70;3885-1697;4105-2308)
Property Tax ID#: 3403-502-0089-000-4 Lot No.60
Site Plan Name: 1862 West Midway Road Block No.
Project Name: Charles R King 1862 West Midway Road
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Selective demolition and removal of Hurricane damaged structure 4 f v d +
6t k ,��r��� -44 r-e l-t-.)ILA.h
cIlR K
CONSTRUCTION INFORMATION:
Acid Itlona I work toe ne rformed under this permit—check all that appy:
HVAC Gas Tank F]Gas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers 11 Generator F]Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ �^� Utilities Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Charles R. King(TR)/Mary L King(TR) Name: C.G.Taylor
Address:PO Box 9 Company: L.E.B. Demolition &Consulting Contractors, Inc.
City: Cedar Bluff State:VA Address: 7 Harbour Isle Drive East 204
Zip Code: 24609 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34949 Fax: 772-461-2225
E-Mail:crking93@gmail.com Phone No. 772-461-4545/772-216=1286
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: CGC1519945/27215
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: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counter 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,1 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 i tend to obtain financing, consult with lender or an torn before
commencing work or_xeeGr-dingybur Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/LicenseUQlder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF saintLude COUNTY OF SalntLude
The fo�going inst ent w s acknowledgeefore me The forgoing instrument was acknowledgeefore me
this day of 6?-- 20 aby this ' day of December 20 by
C.G.Taylor 1 C.G.Taylor
(N me of person acknowledging) me of person acknowledging)
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(Signature of Notary Public-Stateae,,
Signature of Notary Pu lic-State of Florida�\ ,siok•• O.p,��iA8Personally Known x OR�i'o� Rr� l td1� �� Personally Known x OR Produced Idt dim••• •�/rc-��i�
Type of Identification ProduceType of Identification Produced .��QN• � �S.SI�N �•_��
Commission No._GG 083308 = 308 _ Commission No. GG 083308
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Revised 07/15/2014 /i�A�eC�c,STAZE�\���� ��i���iA`.?�bldc Und�.�`��o
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