HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 250 SW AiROSO BLVD PORT SAINT LUCIE FL 34993
Legal Description: RIVER PARK -UNIT 6-BLK 56 LOT 5
Property Tax ID #: 3419-545-0006-000-1
Site Plan Name:
Project Name: 1115963-WOODSIDE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
kw, 1ar wa.n n w u 1 iviStneu unuer Lnis permit — check all apply:
IDHVAC Gas Tank ❑Gas Piping � - � CGenerator
Shutters Windows/Doors
11 Electric Plumbing OSprinklers 0 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 13,090.00
OWNERAESSEE: .
Name NATHAN WOODSIDE
S Ft. of First Floor: _
Utilities: Sewer 0 Septic
Address: 250 SW AIROSO BLVD
City: PORT SAINT LUCIE State: FL
Zip Code: 34983 Fax:
Phone No. 786-748-0924
E-Mail: nathan.woodside@va.gov
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
Name: WAYNE THOMAS BURNETT
Company: FLORIDA HOME IMPROVEMENT ASSOC.
Address: 3044 SW 42ND STREET
City: HOLLYWOOD State: FL
Zip Code: 33312 Fax:
Phone No. 954.792-4415
E-Mail:
State or County License: CGC#061890
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNEI
Name: _
Address:
City:
Zip:
ENTALCONSTRUCTION LIEN LAW INFORMAI`lON,
'ENGINEER: X_ Not Applicable MORTGAGE COMPANY: x Not Applicable
Phone:
State:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: X Not Applicable
Name: _
Address:
City:
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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 Commenceme st be recorded and posted on the jobsite
before the first inspection. If you intend to obtain finar�ci�1�, �t. It with lender or an attorney before
commenci work -or recordingyour Notice of Comme c t.
as Agent for Owner
STATE OF FLORID �ye STATE OF FLORI
COUNTY OF L U COUNTY OF--= IUCvfllf
The fo ng instrum�r1t w acknowledged before me
this -Nday of J C 20'?v by
!name oT person acknowledging)
(Signature of Notary
Personally
Type of Idi
Revised 07/
REVIEWS
BATE
COMPLI
INITIALS
of Florida
OR Produced Identification
The forgoing instrument was acknowledged before me
this lx day ofa.,1�� 20'40 by
WAYNE THOMAS SURNE77
(Name of person acknowledging)
(Signature of Notary Publi to of Florida )
Personally Know OR Produced Identification
Type of Identif. on Produced
UEiL A cRIT�fAdO
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k 19, 2021
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