HomeMy WebLinkAboutBuilding permit application EP
ALL APPLICABLE INFO MUST BE C LETED FOR APPLICATION TO BE ACCEPT a
Date:/0— (. �c� 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 XXX Residential
PERMIT APPLICATION FOR: Concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 5500 Saint Lucie Blvd. Fort Pierce, Florida 34946' j
Legal Description: 30 34S 40E 30 34 40 Beg at SE Cor SW 1/4 of:SW 1/4 Run W on S li of SD SW 1/4 of SW 1/4
333 Feet, Th N to PT on Li of SW 1/4 of SW 1/4 331.2 feet W of NE Cor of SW 1/4 Continued on Tax Roll
Property Tax ID#: 1430-331-00017000/8 Lot No. . Z
Site Plan Name: Road Runner Travel Resort Block No.
Project Name:
Setbacks Front Back:_�Right Side: Left Side: _
DETAILED DESCRIPTION OF WORK:
Remove grass, form and pour concrete 6 inch deep with 3000 psi fibermesh concrete 22' by 63'
with ada approved sloping on driveway.
CONSTRUCTION INFORMATION:
Additional work to e nerformed un er t is permit—check all that apply:
11HVAC 0 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: ST
Ft.of First Floor:
Cost of Construction:$ Utilities _Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Sean Minix Name: Lori Williams
Address: 5500 Saint Lucie Blvd. Company:. D & M Concrete Constuction Inc.
City: Fort'Pierce ' State: F� Address: 33.1"Sunrise Dr.
Zip Code: 34946 Fax:`'�772)464-0987 ::City:'Fort,.Fierce State: FL
PF one No.. (772)A64=0969'"! Zip Code: A34945`"" Fax: (772)468-8667
E-Mail: sean@roadrunnertraveiresort.com Phone No. (772)4-66 4355
Fill in fee simple Title Holder on next page(if different E-Mail: liffie4bit331@yahoo.com.
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.
L ,
SUPPLEMENTAL CONSTRUC ON LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: 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.
Vo-;-u w 4 \J
' LO1 S
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -5;�r COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this/t day of 20 zAy this ZZ_ day of — J 20 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No�,—Ml ��� (Seal) Commission NdQP— 195_9 5 (Seal)
mmafy Public State of Florida W k,. Notezy Public Stale of Florida
,p Karyn G DrawdY Karyn G Drawdy
Revised 07/15/2014 My Commission GG 292585 +} My Commisston GG 282585
" ON d; Expire8 02/11/2023 '►pCr� Expires 02/11l2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS