HomeMy WebLinkAbout001 Permit App - Midway Rd All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:Residential Addition
PROPOSED IMPROVEMENT LOCATION:
Address: 705 E. Midway RD, Ft Pierce, FL 34982
Property Tax lD#: 3402-606-0163-010-6 Lot No.8,9,10
Site Plan Name: Block No. 26
Project Name: Mashaw Residence Addition
DETAILED DESCRIPTION OF WORK:
160SF addition to existing home.Addition includes new lavatory, shower and toilet
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATfON
Additional work to be performed under this permit—check all that apply:
x Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors __.......Pond
x Electric x Plumbing _Sprinklers _Generator x Roof 0.5f12 Pitch
Total Sq. Ft of Construction: 160 Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: _Sewer X Septic Building Height: 8'0
OWNER/LESSEE; CONTRACTOR:
Name Name:Jared Modine -
Address: D _� 4A Company:Cole Construction Services, LLC
City: -ef_(-e ._.-.---State:Iff, Address.497 S. Brocksmith Rd
Zip Code: 3!J61&Z Fax: City: Ft Pierce State:FL
Phone No. ? ")--Z6 — V L Zip Code: 34945 Fax:
E-Mail: 5 i e-FW=j . E q. Phone No 772-519-0558
Fill in fee simple Title 140cler on next page(if different E-Mail coleconstrucfion@ho(mail.com
from the Owner listed above) State or County License 29778
If value of construction Is 2500 or more,a RECORDED Notice of Commencement Is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable i
Name:Pa 1 oion Inc, I Name:
Address: Address:
j City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: I Name:
Address: Address:
City: i City:
Zip: Phone: Zip: Phone:
I
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 1 iome 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording Your Notice of Commencement.
ure of OwneN Lessee/Contractor as Agent for Owner Signature o Contractor/i icense Holder
STATE OF FLORID STATE FFLORIDA
COUNTY OF ;f U i f � C COUN F S1[.(t.a.
Sworn to(or affirmed)and subscribed before me of Sworn or affirmed)and subscribed oefore me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this 20 day of v h, kc�, ut 20212-by i this 2.q day Iof ,202Z by
Name of person making statement. Name of person making statement.
Personally Known X OR Produced Identification Personally n wn_2 OR Produced Identification
i Type of Identification Type of I en fi do
Prod ced Produce
K.
{Signature of Notary Public-St t re of No ry Public-State 1
Nowriddill
otery Public State o Ion a i4' Naotary mes PubMt y Tie o III
sea Modine
Commission
i ly
Commission No.� (l52' Se , Com i ion No. S aIJAyComn HH 284
IIII GG 300523 jof
Expires t0107/2024
Exp.411 412 02 3
REVIEWS FRONT ZONING j SUPERVISOR PLANS I VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE I I
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DATE
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