HomeMy WebLinkAboutBUILDING PERMIT APPLICATION�." SCANNED
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Q3L'2QA-8- 19-A%) 1d Permit Numb
RECEIVED
MAR 2 Z 2018
Building Permit Applicatio
Planning and DevelopmentServices ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Q�rS . _ L
Address: 2829 RAINBOW DR. FORT P
Legal Description: SEC 05TOWN 36E F
Property Tax ID #: 3405-413-001
Site Plan Name: OLGA M WISE 2829
Project Name:
Setbacks Front Back:
E FL. 34981
E 40E
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Right Side: Left Side:
Lot No.
Block No.
d�v TG ',(� "yL(9� i oPVLrvl 5rQ 11 67 V- Y✓L e.*42
o-Ad Seal `J
Haaitionai worK to De perrormea unaer tnis permit- cnecK an tnat apply:
_ HVAC _ Gas Tank _ Gas Piping _ Shutters indows/Doors
_ _Electric _Plumbing Sprinklers _ Generator Roof 4/12 Roof pitch
Total Sq. Ft of Construction: d Sq. Ft. of First Floor: 302
Cost of Construction: $ 12000.00 Utilities: —Sewer _Septic Building Height:
I
Name OLGE M WISE
Name: JOHN G. CANNON
Address:2829 RAINBOW DR
Company: JOHN G.CANNON
City: FORT PIERCE
State:
Address: 7901 CITRUS PARK BLVD
Zip Code: 34981 Fax:
City: FORT PIERCE State: FL
Phone No. 772-466-1275
Zip Code: 34951 Fax:
E-Mail:
Phone No. 772-468-0202 CEL772-201-1771
Fill in fee simple Title Holder on next page ( if
different
E-Mail: JGCANNONROOF(PICLOUD.COM
from the Owner listed above)
State or County License: CCC1330664
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
I
Address:
Address:
City: State:
City: State:
Zip: Phone
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
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 commended prior to the issuance of a permit.
St. Lucie County makes no representation that is gj anting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owilrs 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 lof 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
commencine work or recordine vour Notice of Commencement.
W
o we essee/Contractor as Agent'
for Owner
Signa re ntractor/Li enseHolder
STATE OF FLORIDA � r
STATE OF FLORIDA �_f /
COUNTY OF n�
COUNTY OF n�=�
The forgoing instrqfnent was acknowledged before
this c� (_ day oof�� kAQAfijA20� by
me
The forgoing Instr ment was acknowledg d before me
thisdaynf 20 .by
d_� 4 (fit &- LK 4�
G
Name of person making statement
I /
Name of person making statement /
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification �`� �1 r,
Produced-l�(� t_((�j� 0 (f V
Type of Identification �r
Produce rJ�Q � � �
Ir7-10-755
(Sign a of otary ul�fi,A .1to of Flog FRENCH
"'"•:
o ; Notary Public - State of Florida
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- Stale of Florida
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Commission No. I P = Copp��mmis$$'`on
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# GG 167258
P fires Dec 11, 2021
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Commission NoC� �, . Commi # G 167258
Dec 11, 2021
Bonded Through
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Y My Commit
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Bonded through National Notary Assn.
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(SUPERVISOR
REVIEWS
FRONT
ZONING
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17