HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �r�� j
Date: Permit Number: 1� os- ®3Q4
Building Permit Application MAR2017 ;.
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982 Lucie ounty,FL
Lucie County,,
Phone: (772)462-1553 Fax0(772)462-1578 Commercial Residentials
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 5713 Buchanan Drive
Legal Description: INDIAN RIVER ESTATES-UNIT 02-BLK 6 LOTS 36 AND 37(MAP 34/11 N)(OR 3813-1106: 3825-2069)
Property Tax ID#: 3402-603-0011-000-4 Lot No.
Site Plan Name: Block No.
Project Name: Shepard HW
Setbacks Front Back: Right Side: Left Side:
,,DETAILED DESCRIPTION OF WORK:
Install solar hot water heater- no new electric
6
CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit—c ec a apply:
❑HVAC 11 Gas Tank Gas Piping _Shutters Windows D_ ❑ p g ❑, / oars
❑Electric 0 Plumbing []Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 11987.00 UtilitiesInSewer❑Septic Building Height:
OWNER/LESSEE: 'CONTRACTOR: i
Name Paul&Roxanne Shephard Name: Raymond mead
Address:5713 Buchanan DR Company: LSCI, INC
City: Fort Pierce State:FL Address: 4625 East Bay Drive#305
Zip Code: 34982 Fax: City: Clearwater State:FL
Phone No.7722524813 Zip Code: 33467 Fax: 727-683-9854
E-Mail: Phone No. 727-571-4141
Fill in fee simple Title Holder on next page(if different E-Mail: Permits@suntecsolarenergy.com E
from the Owner listed above) State or County License: CVC056656
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
i
SUPPLEMENTAL CONSTRUCTION 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
commend -work or recording our otce of Commencement.
s
Signatur f Owner/Le see/Contractor as Agent for Owner Signature of ntractor/License Holder
/ i
STAT .OF FLORA r�
STATE OF FLORJDA
COUNTY OF ( �&a �✓ COUNTY OF 0 SCE 1•o,
The fo oing ins u t was acknowledge �jfore me The forgoing instrument was acknowledged before me
this day of 20 1 by this day of NI(ATE c 20 by
tro-mm, , t I Ono] Raymond Mead
a e f person acknowledging) (Name of person acknowledging)
DILL
g to Notary Public- to of Florida) (Signature of Notary Public-State of Florida)
Persona y KnownXPrcni
OR Produced Identification Personally Known_�OR Produced Identification
Type of IdentificatioType of Identification Produced
JA I
C j$sion#FF 94697
Commission No. :. .= c(19;� ommission No. A
My Commission Expires ..
3 N A B TT
••'%i,,OFF `` February 20. 201 8 =•� ' MY COMMISSION#FF870117
INA. EXPIRES March 10,2020
Revised 07/15/2014 aoriavao ea Fwdwriw„ servieo.�an
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS