HomeMy WebLinkAboutBuilding Permit Application f
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l
Date: �" — !R/U� Permit Number:
RECEIVED
Building Permit Application
MAY`2 6 2021
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County
Phone: (772)462-1553 Fax: (772)462-1578 Commercial xxx Residential
PERMIT APPLICATION FOR: Concrete j=
PROPQSEDIN1'PR01/EMENTuLOCATION t ' 4
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Address: 5500 Saint Lucie Blvd. Fort Pierce, Florida 34946
Legal Description: 30 34S 40E 30 34 40 SW 1/4 of SW 1/4-Less a strip of land on a Being 331.2 Feet
on N LI&333 Feet on S LI (or 322-2003)
Property Tax ID#: 1430-331-0002-000/5 Lot No.
Site Plan Name: Road Runner Travel Resort Block No.
Project Name: 5�
Setbacks Front_ Back: Right Side: Left Side:_
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��DTAILD DESCRIPTION r F ORK � �� , ¢ � €� q
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Remove grass, form and pour concrete 4 inch deep with 3000 psi fibermesh concrete aprox
square feet as per plan
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Additional work to be nerf&r—med und er this permit—check all that apply:
❑HVAC Gas Tank []Gas Piping Shutters ❑Windows/Doors
❑Electric ❑ Plumbing []Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: /� S . Ft.of First Floor:
Cost of Construction:$ �lS'� r Utilities:0Sewer❑Septic Building Height:
"01NNER/LESSEE ' .F ;,z ,�,k „" r ,CON TRACTORa�x f,
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Name Sean Minix Name: Lori Williams
Address: 5500 Saint Lucie Blvd. Company: D & M Concrete Constuction Inc.
City: Fort Pierce State: FI Address: 331 Sunrise Dr.
Zip Code: 34946 Fax: (772)464-0987 City: Fort Pierce State: FL
Phone No. (772)464-0969 Zip Code: 34945 Fax:
E-Mail: sean@roadrunnertravelresort.com Phone No. (772)465-4355
Fill in fee simple Title Holder on next page(if different E-Mail:
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.
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St1PPLEMENj AlCO,NSTFUCTIONLIEN LAUU INF x RMATINza j hkr �Po w
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 inspe . If you intend to obtain financing, consult with lender or an attorney before
com men n work a rding your Notice of Commencement.
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_Sign atu)? Signature of Contractor/License Holder
STATE OF FLORIDA S r Ut Cf F STATE OF FLORIDA 5 j LCQ C �.
COUNTY OF COUNTY OF
The forgoing instrument w s acknowledged before me The forgoing instrument /was acknowledged before me
this oZ Uday of M A4 20 RLby this olo day of P1 A\7 20 a 1 by
_k n'I //Jl )< LD,ew W l Di m S
(Name of person acknowledging) (Name of person acknowledging)
0"t;_.) �U0 NA;4� Via.
(Signature 6f 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.
l(�$i91�.KER Commission No. vC'3"'�d
2° 2o°"v'°�� CYNTHIA BAKER.
MY COMMISSION#GG32023
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August I g, NAYISSION#GG366608
EXPIRES:August 18,202
Revised 07/15/20
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS