HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��11 L_, ), �(
Date:- !�-�� Permit Number:at V ' � l
RECEIVED
Building Permit Application MAY 2 6 1011
Planning and Development Services Permitting Department
Building and Code Regulation Division St Lucie County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial xxx Residential
PERMIT APPLICATION FOR: Concrete
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PROPOSED IIVIP.ROVEMENT LQ�CATIQN
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#: 1430-331-0002-00015 Lot No. �a
Site Plan Name: Road Runner Travel Resort . Block No.
Project Name:
Setbacks Front Back: Right Side: �_Left Side: 3
F ak., ✓.' Y.x°' s a'trl# § � Si a ,: ,g"`a...x,
DTAILED�DESCRIPTION,OFWRK �� '��� �',' ,;
Remove grass, form and pour concrete 4 inch deep with 3000 psi fibermesh concrete aprox
square feet as per plan
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CONSTRUCTION INfORMATI0IV m,
Additional work to a formedunder this permit—c ec a apply:
❑HVAC I1 Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑Roof
Total Sq. Ft of Construction: 76.Y S . Ft.of First Floor:
cn+
Cost of Construction:$ a�� y Utilities: OSewer❑Septic Building Height:
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OWNER/LESSEE'S � , xCONTRq F�TOR
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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: Fl 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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SUFPLEIVfENTAL CONSI RC.ICT10 LIEN LAIN INFORMATIO„N'
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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 yo.r property. A Notice of Commencement must be recorded and posted on the jobsite
befor a first ins ion. If you intend to obtain financing, consult with lender or an attorney before
com a cin wor f
cordin our Notice of Commencement.
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_Signatdre of Owner/Lessee/Ag nt Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -ST. ZCGC(F, COUNTY OF 5 7 • 4L (2,4 E_
The forgoing instrument w s acknowledged before me The forgoing instrument was acknowledged before me
this o`�� day of h1)A 20 2Lby this a Oday of In��� 20 L I by
1 66A 0 M WN I_4le4 0J1L _dA9W 5
(Name of person acknowledging) (Name of person acknowledging)
�Wwu,;; 4 ",Vj &hwt;_0_, 60ejL)
(Signaturg of Notary Public-State of Florida) (Signatu a of Notary Pu Iic-State of Florida)
Personally Known I/ OR Produced Identification Personally Known OR Produced Identification
Type of Identification
Produced Type of Identification Produced (/
Commission No. vV 3� Commission No. G� ��0a
CYNTHIA BAKER °,�YP�&� CyNTHIA BAKER
hAvrommi ION#GG366608 = #GG366608
` tea°4wl EXPIRES:August 18,2023 � QI EXPIRES:August 18.,2023
Revised 07/15/2014 °F"°
REVIEWS FRONT ZONING SUPERVISOR 'PLANS VEGETATION SEA TURTLE MANGROVE
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