HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MIDST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
LactL
V ' Ty, Building Permit Application
Ran ning and 0�-velopment Services
Buflding and Code Reguh3fian Division Com m ercial Residential X
23W Virgirrra Avenue, Fort Pierce FL 34982 —
Phone: (7721 4f2-1553 Fax: (772) 462-IS78 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION.,
Address: 3415 S Indian River Drive. Ft Pierce- FL 32982
Property Tax iD #. 2426-133-0001-000-0
Site Plan Narne:
Project Name' Campbell
DETAILED DESCRIPTION OF WORK:
Duck Replacement
Lot Nn-
Block No -
New Electrical Meter \ ..% Second Electrical Meter N A {Affidavit required}
CONSTRUCTION INFORMATION:
Additional work to be Perforated under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters—INfndowsf Doors Pond
Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: _ 2358 Sq, Ft. of First door:
Cost of Construction; 5 150,000,00 Utilities, _ Sewer — Septic Building Height- ,
OWNERf LESSEE:
Name Briars Campbell
Address: 3415 S Indian River Dr.
City: Fi Perice State: 1' L
Zap Code: 34982 Fax.
Phone No- 772-913-2520 �-
mail: brian nzcarttl)bI14' .vahoo.corn
Fill in fee sim pie Title Holder on next page (if different
from the Owner listed aboveI
CONTRACTOR:
Name: Douglas R Loseke
Ccrnpar,y: Continental Associates. Inc.
Address; P.O. Box 731953 _
Cfty_ Ormond Beach, F1 State- FI.
Zip Code: 32173 Fax:
Phone No772-913-2520
E-Mall dau u contineptalassoc.com
State or County License CBC014130
FT uRitke of consxruction is 1SUtl or mare, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commenternent is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFOR 1ATION-
DE516NERJENGINEER: _ Not Applirable
Name. Ryan lurra , PE
Address.1648 Taylor Road -w7400
CitY= Port Quin e State: FI _
Zip: 32128 Phone 407-28 -7?37
FEE SIMPLE TITLE HOLDER:
Name;
Address:
City,
Zip: Phone: _
'A— W Applicable
MORTGAGE COMPANY
Name. _
Address;
City:
Zip:
Phone:
."'A —foot Applicable
ate:
BONDING COMPANY.- N. A _Not Applicable
Name:
Address:
City_
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: AppIIration is hereby made to obtain a permit to do the work and instalhotion as indicated.
I certify that no work or instaIbtion has Commenced prior to the! issuance of a permit,
St. Lucie County makes no representation that is ggrantin a permit will authorize the permit holder to build the subject structure
which Conflicts with any applicable Homeowners ASSOCIi�n rules, bylaws Dr and Covenants that may restrict or prohibit su Ch
structure. Please consult with your Homeowners Association and review your deed for any rest ridians which may apply,
In consideration of the granting of Olds requested permit, I do hereby agree that I wl11, in all respects, perforrn the work
in accordonce with the approved plans, the Florida Building Codes and St_ Wcie County Amendments,
The following building permit applications are exempt from undergoing a full con currency review; room additions,
accessory Structures, swimming pools, fen{es. W015, 51gnS, screen rooms and accessory uses to another non-resident Iall use
WARNING TO OWNER: Your failure to Fte€ord a Notice of Commencement may result in paying Wre for
Improvements to your property. A Notice of Commencement must be recorded in the pubk records of St.
Lucie County and posted on the jobsite before the first inspection_ If you intend to obtain financing, consult
with r or an attorney before cornmenciing work or recording our Notice of Commencement,
signature of nrf iesseefcontraetpr aSAgnt fbr Owner
STATE F FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed befog,- me of PhyrdraI Presence or Online Notarization
this day of 20;4 by
Name of pers6n i g sta(�ment_
Personally Known ... OR Produced Iden ification
w • Ki�ii EN J- Yi eDROWH
Type o Identification Produced
wary Public. ftid o{ FWWO
gmripysivN HH 40012
N1K mrnm rpxonm N00. 17, M24
}
{signature of atary stat of Florida)
[c,
Commission No. V 5eaI
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION ' SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
1cY .2j e-ul L•