HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR
Date:
SON
Buildini
�PLICATION TO BE ACCEPTED
Permit Number:
RECEIVED
Permit Applicati n APR 12 2018
Planning and Development Services
Building and Code Regulation Division
LST.Lucie Gabfi�J E�gt°ffllttiilq
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential X
PERMIT APPLICATION FOR: Building
PROPOSED 11VIPROVEIVI'ENT LQCATIO'N
v ,
Address: -1.S-52 / -7
5
3805-1197
Legal Description: TREASURE COAST AIRPARK LOT.85,
Property Tax ID #: PARCEL ID 4224-501-0085-000-
Lot No.85
Site Plan Name:
Block No.
Project Name: J.R. MORAN HOME
Setbacks FronlW�� Back: 30FT Right
Side.) r''�1 e Side:
I
DE7FAILE'D'iDESSCRIPTION OF WORK
a,
140-1� a / InbaL 5 -L rz W /, -2 be, 7- " l
tCONSTRUC�TIONIIN,FORM`ATION
Additional work to be nertormed under this perm�t
— check
all apply:
Lv' JHVAC L I Gas Tank ❑✓ Gas P
ping
_ Shutters
✓a
Windows/Doors
0 F�Sprinr
Roof
L'J Electric Plumbing
lers
Generator
Roof pitch
Total Sq. Ft of Construction: 5676���-;G
S . Ft. of First Floor:
Cost of Construction: $
Utilities: Sewer Septic
Building
Height:
OWNER%LESS'EE°'JO,HN rR' MO'RANfAl ,'//;
{
"CONTRACTO,R J;OHN
R MORAN
Name .JOLy� 4 P- ii/f✓
Name: JOHN RAYN MORAN-OWNER
Company: i
Address:13307 POLO CLUB RD C107
City: StatelFL
Address: 630 1 9,2,Qt46ee_
Zip Code: 33414 Fax:
City: E State:
Phone No. 772 444 7926 1
`�
Zip Code: 37�So Fax:
E-Mail: JRYANMORAN@GMAIL.COM
Phone No. O
Fill in fee simple Title Holder on next page ( if different
E-Mail: C
State or County License: C'RC / 25'7 V5
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
S PPLiUIE TP►L CO(US R�UCT'tN LN IOW tUFOR+ ATiG
DESIGNERI,ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone
I
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
Zip: Phone:
1
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 Builc)ing 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, sighs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record alNotice 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 recording vour Notice of Commencement.
Signature of'Owne/
,A Less
STATE OF FL
COUNTY OF
ctor as Agent for Owner I Signature of
The fo oing instrument N as acknowledged efore m
this day of 20M by
Name of person making\statement.
Personally Known �'1j_ OR Produced Identification
Type of Identification
Produced
(Signature o otary P e Rt Qi� - re
u _ Floridz.
• « - Commission i} F( 23. ;73,1);
Commission No. 9 �o:;: My Comir(plas May 27; 201'9
Bonded through National Notary Assn.
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
der
STATE OF FLORIA�� '
COUNTY OF �J C-A-Q—
The for o.� ing instrumen was acknowledged before me
this nday of20 18 by
:r� MOA:bq PN ,c;_:-�
Name of person makin tatement.
�ersonallyOR Produced Identification
Produced
"��np A 6L-, 0)
(Signature of)rotary Public: -State of Florida )
Commission No.
ZONING SUPERVISOR- PLANS VEGETATIONi h E. �T,� W
REVIEW REVIEW REVIEW REVIEW REVIEW
REVIEW
All APPLICABLE INFO MUST BE COWPLETED F'OR APPLICATION TO BE ACCEPTED
Date: Permit Number:
t.w
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
PERMIT APPLICATION FOR:
Address:
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
Left Side:
Residential
Lot No.
Block No.
Additional worK to be pertormed., under this permit — cnecK all that apply:
_Mechanical _ Gas Tank Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer —Septic Building Height:
Name
Address:
City:
Zip Code: Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if
from the Owner listed above)
Name:
Company:
Address:
i
State: _
City: State:
Zip Code: Fax:
Phone No
i
different
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.