HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ((j�
Date: Permit Number: l�� • ��D�1
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECEIVED
Building Permit Application APR16.1019
Permitting Department
St. Lucie County
Commercial X Residential
PERMIT TYPE:
P.-RDPQ$ D IMPROV MENT lC?C�T[O �� �� .
i A 'I^' % .. F
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Address: -�0'70 JOVNM rd. FT- A race F4 3I(991
Property Tax ID #: 3403-502-0194-000-3 Lot No.
Site Plan Name: Treasure Coast Hospice Block No.
Project Name: vi"
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Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
�,j_ Electric Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 121,000.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
01It/N�EFi%LESSEE k _
so
CONTRACTOR ,a g �. v
Name The hospice Foundation of Martin and St. Lucie
Name: Brandon Nobile
Address: 1201 SE Indian Street
Company: Remnant Construction
City: Stuart State: _
Zip Code: 34997 Fax: 772-403-4518
Phone No. 772-403-4506
Address: 201 South 2nd Street, Suite 207
City: Fort Pierce State: FI
Zip Code: 34950 Fax: 772-264-3108
Phone No 772-577-5850
E-Mail bnobile@remnantconstruction.com
E-Mail: mfournie@treasurehealth. Or
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License CBC1261746
If value of construction is S2500 or more. a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Jw .SLo-1r+ (2r- -yc_l , Name:
Address:, --)g a,r tea,. ,,�.,� Address:
City: J ' State: P— City: State:
42
Zip: a Phone 5(vd-y,?Jcl Zip: Phone:
FEE SIMPLE TITLE HOLDER: V Not Applicable
BONDING COMPANY:
Name:
Name:_
Address:
Address:
City:
City:_
Zip: Phone:
Zip:
Phone:
of Applicable
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
ITH YOU DER OR AN ATTORNEY BEFORE RECORDING YOUR NOTI F COMMENCEMENT."
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Signatu of Owne"F744sWcontractor as Agent for Owner
Signa of Contractor/License Holder
STATE OF FLORI
STATE OF FLORIDA
COUNTY OFff
COUNTY OF
The ing instr ent as acknowledg before me
The f r ng ins tr ent ><v s acknowledge before me
th day of 20 by
thi�rday of 20f by
&,rlu e-
Name of pers n making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
d
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4inn,
Produce
114 54yd
ure of Notary Public- State of Florida
g ture of Notary Public- State o Io�?' o Notary Public State of
Linda S French
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Commission No. 0e-7 d0 e° e4�( fii� S French
q a M Commission GG 1
C mission No. IoZOo�� '� °dl y
?o Expires 07/04/2021
�a My Commission GG 120210
Expires 07/04/2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19