HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \a Permit Number: `i \ a 0 old a.
� li '� A {„�•pl t
RC. c
Building Permit Applicatiol"
n O op �011
Planning and Development Services E 0
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Address: 16 Hermosa Lane Port Saint Lucie, FL
Legal Description. See Attached
Property Tax ID #: 3414-501-1701-000-9
Site Plan Name:
Commercial Residential*X°
Project Name:
Setbacks Front_ Back: Right Side: �_ Left Side:
DETAILED DESCRIPTION OF�WORK > �.
Carport A OA &13A
❑HVAC u Gas Tank ❑Gas Piping
11 Electric 0 Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ `"rl goo n
LJ Shutters
❑ Generator
Roof
Lot No.
Block No.
iuoors
Roof pitch
S Ft. of First Floor:
Utilities:Sewer 0Septic Building Height:
CONTRA
Name Paul Shackleton
Name: Gary Whigham
Company: South Florida Aluminum Products
Address: 16 Hermosa Lane
Address: 4807 SO US HWY 1
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 772-466-1074
City: Port Saint Lucie State: FL
Zip Code: Fax:
Phone No. 61 9;974-0919
E-Mail:
Phone No. 772-466-0913
Fill in fee simple Title Holder on next page ( if different
E-Mail: sfapbooks@soflalum.com
State or County License: CRC1330712
from the Owner listed above)
If value of construction is 52500 or more, a REGURUtU Notice or Lommeneement is reyuueu.
i
UAPLMENTAL CONSTRUCTION LIEN LAU1! INFORMATION
r. ` r
DESIGNER/ENGINkER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: .foxLoas t A&A. 6-A
Name: G
Address: 1 0P $ T /D/
Address:
City: State:
City: State:
Zip: 6 Phone 727-S'?Z"f606
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Add ress:
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
property. A Notice of Commencement must be recorded and posted on the jobsite
improvemen��a
before th irion. If you intend to obtain financing, consult with len raK a attorney before
comm cin ecordin our Notice of Commencement.
If
Signa ner/ Lessee/Contractor as Agent for Owner
STATE OF FLO DA
L
o Co se Holder
STATE OF FLORIDA
COUNTY OF 10 1 L ve�cLP
COUNTY OF .)Q 1141 ae,7y
The form'ng instrWenj was a knowledged before me
this�"tay of 20� by
The forgw' g instr ment was acknowledged before me
thiI day of y 20fQ by
Name of person m k(ng statement
Name of person, making statement
Personally Known OR Produced Identification
Personally Known --I OR Produced Identification
Type of Identification
Type of Identification
Produced
Producer.!
(Signature N tary Public- State of Florida)
(Signatur o Notary Public- State of Florida )
Co 1744 00- TONe I)
MY COMMISSION 14 FF953138
Com is d'b-b q.ATOflITI':
- MY
c;.EXPIRES
COM SIGNMfS N FF953138
OEXPq
:dGr
REVIEW
FbrulaNn;n•vS;.'wtaoxn:.
SUPERVISOR
�:+r,.�;•yt
PLANS
VE FM,nrIINr,:•
drY24. 2020
'. c ,f E
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
�1^
(
1.46 — I-?
RECEIVED
DATE
COMPLETED
Rev. 8/2/17