HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLICABLE INF�MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: p.c - d O
• Number: �tW
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Building Perm_ it Applicat on RECEIVED
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Planning and Development Services
v N Q 40 18
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772) 462-1553 . Fax: (772) 462-1578 Co mercial —R2Sl
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PERMIT APPLICATION FOR: Building
PROVEMENT LOCATION: a
Address: 1 1820 W Midway Rd Fort Pierce, FL 34945(0/1/
Legal Description: WEST MIDWAY (PB 45-1) LOT 1 (2.69 AC) (OR 3742-168)
Property Tax ID #: 3304,�603-0002-000-7 Lot No.
Site Plan Name: Tyson Residence Block No.
Project Name: TysonResidence, r/
Setbacks . Front2_7 tBack:' 2Si) Right Side: C7 Left Side: _/d
L�EI�
E ESCRIPTIOIV OF WORK.
New Singe Family Home
CaT10N INFORMATION;
itiona work to beperformed under tispermit—check all apply:
EI/IHVAi- Ir J Gas Tank Gas Piping Shutters a Windows/Doors
_
ZElectric ✓❑ Plumbing OS ri klers Generator Roof Roof pitch
Total Sq. Ft of Construction:) S Ft. First Floor:
. of
r
Cost of Corstruction: $ 2S�51 O�� Utilities: _Sewer LYJ Septic Building Heigh_
EE VU1f (���L'ESS:...
,ONTRACTOR_:
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Name James and Michelle Tyson
Name: Jared Modine
Company: Cole Construction, Services
Address:11820 Midway Rd .
City: Ft Pierce . State: FL
Address: 497 S. Brocksmith Rd
City: Ft Pierce State: FL
Zip Cocle: 34945 Fax:
Phone No. 772-321-7658
Zip Code: 34945 Fax:
Phone No. 772-519-0558
E-Mail: coleconstruction@hotmail.com
E:-Mail:_
a I in fee simple Title Holder on next page ( if different
the Owner listed above)
State or County License: 29778
construction is $2500 or more, a RECORDED Notice of Commencement is required.
f�•
SI�II ILI MENTAL' CONSTRUCTION LIEN' LAW INFORMATION:
DESIGNER ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Narne:_ -rt , 0nr C_1 (r.C�
_
Name: 5 -, w&sr / , K
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE. SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:_
Name:
Address:
Address:
City:__
City:
Zip: Phone:
Zip: Phone:
OWNER/ I"ONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify thav 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 st,uctures, 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 vdork or recording your Ngtjce of Commencement. % A
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Signature of will Ier/ Lessee/Contractor as gent for Owner
Signature of Con ractor/License Holder
STATE OI F ORIDA
STATE OF F IDA
COUNTY OF Si . WC/E71
COUNTY OF _517 LNCaC
The fo joing instrument was acknowledged before me
s�Cay
The f going instrument was acknowledged before me
this of ogir 20 a_ by
this day of 20_hS by
A1tE� IMODINE
JARt"n MOD�NE
__�_
Name of perso�aking statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known ,/ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Pub
(Signature of Notary Publiii
o,' a Notary Public State of Florida
o'0r •, Notary Public State of Florida
Commissicn No. FF 2$ ` Grele� Kraum
Commission No. I~ F Grelg@gr,Kraum
My d ion FF 232514
aMy Commission FF 232514
.,o- Expires 05/19/2019
�,�
OF nog Expires 06119/2019
REVIEW!;
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
I�
RECEIVED
DATE
COMPLETED
iev. 8/2/17