HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST
/BE COMPLETED FOR APPLICATION TO BE ACCEPTED )i.
Date: / �f Permit Number: 14 1 P--y cQsS
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15.53 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of .line
PROPOSED IMPROVEMENT LOCATION:.
Address: 10851 S. Ocean Drive, Lot #84, Jensen Beach, FI 34957
Legal Description: Windmill Village Condominium 1, Lot # 84, Jensen Beach, FI. 34957. Book,page 3042-2097 range 41 E township 37S
Property Tax ID #: 4511-810-0091-000/2.
Site Plan Name: Ana & Ted Ferguson home
Project Name: Ana & Ted Ferguson home
Setbacks Front -10 Back: 5'_ _
DETAILED DESCRIPTION OF WORK:'
Construct 2 story home
Right Side: 0,• 32) Left Side: 8'
Lot No. 84
Block No.
Additional work to be
WIHVAC
nertormed
Gas Tank
under this permit — cneck all
Gas Piping
tnat
apply:
Shutters
Q Windows/Doors
_
Electric
0
Plumbing
Sprinklers
Generator
Roof
Total Sq. Ft of Construction: 1950 sf S�Ft. of First Floor: 845 sf
Cost of Construction: $ 190,000;, 00 Utilities: lr ISewer Septic Building Height: z2fPomfinsishfloor
OWNER/LESSEE:
; CONTRACTOR:. -
Name theodore ferguson
Name: owner build
Address:3543 Halegate Ct.
Company:
Address:
City. Oviedo State: FL
Zip Code: 32765 Fax:
City: State: FL
Phone No. 407-722-4669
Zip Code: Fax:
E-Mail: ferguson92@aol.com
Phone No.
E-Mail: Ferguson@gibbsandregister.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License:.
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLE MENTAL`CONSTRUCTION LIEN LAW INFORMATION;
DESIGNER/ENGINEER: x— Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name: Roboleck
Name:
Ad d ress: 1219 Scarlet Oak Loop
Address:
City: Winter Garden State: FL
City: State:
Zip: 34767 Phone: 407-296-3593
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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 workor' recording your Notice of Commencement.
of Owner/ Aitent/ Lessee
Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF r na 0 COUNTY OF
The forgoing iristr ment was acknowledged before me The forgoing instrument was acknowl,
this�dayof Cambe V 20 14 by this �day of �Lc2ct�btY
(!DOJO✓y t f:! j vs-0 I hwdoa_ f-e
'
(Name of person acknowled g) (Name of person acknowle
(Signature of Notary Public -State of Florida) (Signature of N
Personally Known i1 OR Produced Identification Persona
Type of Identification Produced Type of
NOTARY FL,:.;C• 'iA:;. JY FLORIDA
Commission No. (0 Q R•(Seal ]a u, Turner
Commission # EE101960 C/o
Revised 07/ 15/2014 �BONbb THAV ATLANTIC BONDING CO., RM
Public- State of Florida )
by
me
Town �_ OR Produced Identification
:ification Produced
No. �CtiIOIaVa NOTARYP�' �I+�i:'DO OF
�tia
�I� Commission # EE101960
THRO ATLANTIC BONDING CO., INC,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS