HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 2-28-18t
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/28/2018 Permit Number: 1706-0396
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial XX Residential
PERMIT APPLICATION FOR:
Other
PROPOSED IIVI;PROVEMENT
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Address: 13821-13825 S. INDIAN RIVER DR., JENSEN BEACH, FL 34957
Legal Description: RES/D OF 9110-37-41 FROM SE CORSEC 9 RUN N ALG E SEC LI 900 FT MIL, TH ELY TO W R/W INDIAN RIVERDR AND POB
Property Tax ID #: 4509-801-0015-000-1
Site Plan Name:
Project Name:
Setbacks - Front Back: Right Side: Left Side:
"DETAIL`ED"DESCRIPTION OAF WORRK
AFTER THE FACT PERMIT FOR UNPERMITTED WORK BY PREVIOUS OWNER.
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Itlona work
.. to: e:..e _ orme . under...., ...
t Is permit—checka apply:
RjHVAC Gas Tank Gas Piping Shutters Windows Doors
p g � �
RElectric Plumbing Sprinklers Elenerator 11 Roof Roof pitch
Total Sq. Ft of Construction: 1800 S n_'Sewer
of First Floor: 1800
Cost of Construction: $ #% 41"6Utilities: septic Building Height:
Name INNER HARBOUR PROPERTIES LLC
Address. 770 SE INDIAN ST Name:'MICHAEL MOTTO
City: STUART Company: SOUTHERN BUILDING ENTERPRISES
Zip Code:
34997 State:Fl Address: 812 SE LINC(JLN ST
Fax:
Phone No.954-278-0009 City: STUART
E-Mail: BHILL@TREATMENTLLC.COM Zip Code: 34994 State: FL
Phone No. 772-219-8005 Fax:
Fill in fee simple Title Holder on next page ( if different E-Mail: MIKE@SOUTHERBLDG
from the Owner listed above) .NET
State or County License:7CGC1515502
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL''CONSTRUCTION LIEN .,L'AW'INFO:RMATtON :.
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Add ress:812 SE LINCOLN ST
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recordine vour Notice of Commencement.
"
Sign ture of Owner/ Lessee/Contractor as Agent for Owner
S gnature of Cont actor/Licen a Holder
STATE OF FLORIDA r
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STATE OF FLORIDA '
COUNTY OF 54UtI�
COUNTY OF
The forgoing instrument was acknowledged before me
this I day of IMcxYt,� . 20_a by
The forgoing instrument was acknowledged before
this _L day of IM 0-(,n , 20 by
me
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Name o erson making statement
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Name of person making statement
Identifica
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Personally Known OR Produced Ident
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Personally Known OR Produced
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Type of Identification
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Type of Identification
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Produced
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Produced
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(Signature of Notary Public- State of Florida )
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(Signature of Notary Public- State of Florida )
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Commission No. �F �0 `j�� (Seal
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Commission No. �� %30 �ci� (Seal)
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REVIEWS
FRONT
ZONING
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17