HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )
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_ MAY 15
2019
Building Permit Application
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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 XXX Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
P'R'OP.O'SEDIIVIPROVEMENT LOCATION ,, .. '" = '
Address: 5500 Saint Lucie Blvd. Fort Pierce, Florida 34946
Legal Description: 30 34S 40E 30 34 40 SW 1/4 of SW 1/4-Less a strip of land on a Being 331.2 Feet
on N LI &333 Feet on S LI (or 322-2003)
Property Tax ID#: 1430-331-0002-000/5 Lot No.
Site Plan Name: Road Runner Travel Resort Block No.
Project Name: SL��rI
Setbacks Front- Back: Right Side:_ Left Side:
DETAILED DESCRIPTION OF WORK
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CONSTRUCTION INFORMATION
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Additional work to be performed under this permit—check a appy:';;
OHVAC _Gas Tank Gas Piping Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers E Generator 0 Roof
Total Sq. Ft of Construction: �' S . Ft. of First'Floor:
Cost of Construction:$ 000 Utilities:,n Sewer F]Septic Building Height:
O:WNEft/LESSEE CONTRACTOR
Name Marilyn Minix Name: Lori Williams
Address: 5500 Saint Lucie Blvd. - Company: D & M Concrete Constuction Inc.
City: Fort Pierce State: FI Address: 331 Sunrise Dr.
Zip Code: 34946 Fax: (772)464-0987 City: Fort Pierce State: FL
Phone No. (772)464-0969 Zip Code: 34945 Fax:
E-Mail: sean@roadrunnertravelresort.com Phone No. (772)465-4355
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: #24764
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL-CONSTRUCTION LIEN LAW'INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: —
Name:
Address: Address:
City: State:
ZCity: 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:
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 you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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_Signature of Owner/Lessee/Agent �., Signature of Contrac or License er
STATE OF FLORIDA a c5j' STATE OF FLORIDA
COUNTY OF � 6ve COUNTY OFCo 02
5% Ciel
The Bing instrument was acknowledged bef "W The forgoing instrument was acknowledged before me
this day of CA20 �b o g 9 this tS r day of mlq V 20 by
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(Name of person acknowledging) o? (Name of person acknowledging)
(Signature of Not Public- tate of Florida-T— (Signat re of Notary Public-State of Florida)
Personally KnownO
Produced Identification Personally Known J OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. rF�3/F 41
2.1 ��:TIi1A BAKff ER
Revised 07/15/2014 V Q�` ��xEs:June 29,zo 19
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS