HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: zxisvl%�_
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Building Permit Application MAY 2 6 2021
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 1
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PROPOSED IMPROVEMENT LQCATI,4N '
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) f
Property Tax ID#: 1430-331-0002-000/5 Lot No. '27
Site Plan Name: Road Runner Travel Resort Block No.
Project Name:
Setbacks Front_ Back:��Right Side: v Left Side:� +,
i ;giK?*,; "a"'�n6,5.aa":' tr'a'�g.-s".'=s'3�+ i ;:+*es<"' 4 c- r ...J '��`'`?g*3'W$r$u Vt ,x �+. "e �'�F nr ays 2 :,•q ��l `"s1 ,Eny 9p"a ` r s�X.�n� .
Remove grass, form and pour concrete 4 inch deep with 3000 psi fibermesh concrete aprox 640
square feet as per plan.
Additional work to b e nertormed under this permit—check all 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:$ f dad utilities: Sewer❑Septic Building Height:
OVUM k t SSEE" f x r x COxNTRACTOR �y "
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@roadrunnertraveiresort.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.
15, '
�SUP�PLENIE NST�R'tJCTIONI�.I�Ef�M�LAIN�INF
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 pr , rty. A Notice of Commencement must be recorded and posted on the jobsite
before th 'rst inspecti you intend to obtain financing, consult with lender or an attorney before
comme cin ork or r c our Notice of Commencement.
U& AhL S
_Signature of Owner/Lessee Agent Signature of Contractor/License Holder
STATE OF FLORIDA ,5 LCLCI� STATE OF FLORIDA ST �Gt E.
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this oho day of MAY 20 al by this 10 day of MAY 20 a ) by
SCclvl Jo Zoo Wie-uriv»S
(Name of person acknowledging) (Name of person acknowledging)
afto'�' �avu 4
bu
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.99-1 WDOW (Seal) Commission No. 61v 3 6
CYN'I'HIA BAKER
MY t'(w,%IISSION#GG366608
MY COMMISSION#GG366608 �FlOP° EX P i,ti 1"" August 18,2023
Revised 07/15/2014 �� EXPIRES:August 18,2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS