HomeMy WebLinkAboutFlood Permit AppALL APPLICABLE INFO MUST HE COMPLETED FOR APPLICATION TO BE ACCEPTED
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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 C_
PROPOSED IMPROVEMENT LOCATION:
Address: 1012 Flood Rd
Legal Description: WHITE CITY FROM NW COR OUTLOT 6 RUN E ALG N LI 150 TO POB, TH CONT ALG SD N Li 130 FT
TH SLY 170 FT, TH WILY 130 FT, TH NLY 170 FT TO POB (0.51 AC) (OR 2207-1080)
Property Tax ID #: 3404-501-0517-000-4
Site Plan Name: Flood Lot No.
Project Name: Flood
Block No.
Setbacks Front ^T Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Service change
CONSTRUCTION INFORMATION:
Itiona wor to e��e orme un ger t
HVAC I_J Gas Tank
Electric Plumbing
Total Sq. Ft of Construction: 1227
Cost of Construction: $ 2000
OWNER/LESSEE:
Name Melissa Barnhardt
peiinn — cnecx aii 1= apply:
Gas Piping Ll Shutters
Sprinklers 1:1 Generator
SFt. of FirstFloor:Floor: _
Utilities:,n Sewer 0Septic
Address: 1012 Flood Rd
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
QWindows/Doors
0 Roof Roof pitch
Building Height:
CONTRACTOR: -
Name: Donald 8 Green
Company: Don Green Electric LLC
Address: 1305 W 1st Street
City: Fort Pierce FL
State:
Zip Code: 34982 Fax:
Phone No. 772-418-5739
E -Mail: dongreenelectdc@gmaii.com
State or County License: EC 13007447
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/EIVGINFFR• �t..+ n......:__�i_
Name:_
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Not Applicable
State:
Zip: Phone:
BONDING COMPANY:
Name:_
Address:
City:
Zip:
Phone:
Not Applicable
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 CountyY makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 1 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, consult with lender or an attorney before
Commencing work or recording our Notice of Commencement_
Signature of Owner/ Lessee/Contractor as
Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
this day of 20_ by
DONALD B GREEN
Name of person making statement
STATE OF FLORIDA
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
this day of 20 by
DONALD B GREEN
Name of person making statement
Personally Known X OR Produced Identifirntinn
Commission N
My Commission Expires
January 5. 2020
REVIEWS FRONT ZONING SUPERVISOR PLANS
COUNTER; REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. $/2/17
VEGETATION f SEA TURTLE I MANGROVE
REVIEW I REVIEW REVIEW