HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/17/2020 Permit Number:
S J �
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 x Residential
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: 4451 Saint Lucie Blvd.,Fort Pierce,FL 34946
Legal Description. 31 34 40 W 1/2 OF NE 1/4 OF NE 1/4-LESS N 118 FT FOR RD AND CANAL RS/w-(18.62 AC)(OR 1335-2036)
Property Tax ID#: 1431-112-0001-000-8 Lot No.
Site Plan Name: A-1 Truss Expansion Block No.
Project Name: A-1 Truss Building 115
"Prw=352.5 Min.=25' Pro,=766.833 Min.20'
Setbacks Front Back: Right Side: Pr=371•,Min-,o, Left Side: Pr=263•M;n-,�
DETAILED DESCRIPTION OF WORK:
Utility Structure T-Shed used for storage.
CONSTRUCTION INFORMATION:
Additional work to a Der formed under this permit—check a apply:
11HVAC E] Gas Tank Gas Piping _Shutters Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers Generator Fv-] Roof 1 :12 Roof pitch
Total Sq. Ft of Construction: 3600 S Ft.of First Floor: 3600
Cost of Construction: $ 125,000 Utilities:cn Sewer[]Septic Building Height: 18,
OWNER/LESSEE: CONTRACTOR:
Name John Herring Name: Donald L.Tolliver
Address:4451 Saint Lucie Blvd. Company: Proctor Construction Company,LLC
City: Fort Pierce State:FL Address: 2050 US Hwy 1,Ste 200
Zip Code: 34946 Fax: City: Vero Beach State:FL
Phone No.561.436.3454 Zip Code: 32960 Fax: 772.234.8188
E-Mail:lohn.herringpaaitruss.com Phone No. 772.234.8164
Fill in fee simple Title Holder on next page( if different E-Mail: vbrownC@proctorcc.com
from the Owner listed above) State or County License: CGC1522209
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Rama Pranav Knslam FL PE e88906 Name:
Address:4451 S Woe Bind.Sme201 Address:
City: FonP.r State: FL City: State:
Zip: 34946 Phone 7240910C' Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _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 you intend to obtain financing, consult with lender or an attorney before
co-mmencing work or recording our Notice of Commencement.
A�
Sig E re of Owner/Lesse /Contractor as Agen Af Owner Signature of Contractor/Li ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF---, COUNTY OF —n—,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_lZ day of 2 P by this 11h day of Aug- 20 20 by
John Herring Donald L.T.P.—
Name of person making statement Name of perso making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Iype of Identificat on Type of Identification
Pr Produced
mono
(Signature of ary Pu ic-State of r,aY),,,, PAIG E P Notary Public State of Florida)
State of Florid Nolaty,Puhl cl GG207836
Commission No. N _ Commission M4si01N`�. DBaOWN
+•fo,r o`, 1y Commis for 'c r a, f:, Notary Public-State of Florid+
" October 4, 2022_� = p`r Commission u GG 207836
cf` it s Au 12 202 2
Bonded through tiondl Nolary Assr.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIO
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17