HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dat �' �� 1Permit Number:
SCANNEDBY
^ r r- ` , _ - St. Luciec®Untll RECEIVED
Building Permit Application AUG 10 2018
Plan ing and Development Services
Buildjng and Code Regulation Division ST, Lucie County, Permitting
23001 Virginia Avenue, Fort Pierce FL 34982
Pho e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential k4
PERMIT
APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRO
OSED IMPROVEMENT LOCATION:
Addre' s: 4245 S Indian River Dr
Legal description: 35 35 40 BEG AT PT ON W LI OF E 1/2 OF NE 1/41255.36 FT N OF S LI OF SE 1/4 OF NE 1/4
TH RUN N 100 FT, THE TO RIV, TH SELY ALG RIV TO PT 1255.36 FT N OF S LI OF SE 114 OF NE 1/4, TH RUN W TO POB WITH RIP RTS-LESS RD AND FEC RR- (14)
Prop IIIy Tax ID #: 2435-113-0007-000-8
Site P an Name:
Proje Jt Name:
Seb I,cks Front Back:
DET ILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
—Addittiona worK to be Derformed under
Total
Cost
IVAC Gas Tank
lectric Plumbing
a. Ft of Construction:
Construction: $ 3495.00
Right Side:
Left Side:
Lot No.
Block No.
this permit — crhecK an appiy:
Gas Piping Shutters Windows/Doors
Sprinklers FIGenerator Roof Roof pitch
S Ft. of First Floor:
Utilities: — Sewer Septic Building Height:
OW
ER/LESSEE:
CONTRACTOR:
Nam
Addrlf7ort
City:
Zip C
Phon
E-Ma
Fill in
from
Rosalie Bloehm
Name: Blake Cowdell
Energized Gas
Company: 9
s: 4245 S Indian River Dr
Pierce State: FL
l de: 34982 Fax:
No.772-461-1656
Address: 4252 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
Phone No. 772-466-1095
il:
fee simple Title Holder on next page if different
the Owner listed above)
Ener )zedGenerators mail.com
E-Mail: 9 @9
State or County License: �i4T�
If valuo of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESrGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Na �e:RosalieBloehrn Name: BlakeCowdell
Ad dill ess:4245 S Indian River Dr
City Fort Pierce State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Na Ile:
Ad d reSs: 4252 Bandy Blvd
0
one:
Address: 4245 S Indian River Dr
City: Fort Pierce State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certi I that no work or installation has commenced prior to the issuance of a permit.
St. Lucle 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
structi re. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In con�hderation of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acc ,,rdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fo lowing 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
WARMING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impr I vements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befoe the first inspection. If you intend to obtain financing, consult with lender or an attorney before
nnmmonrinn %nrnrL nr rornrdinn vnrrr nintir0 of r nmmanrampnt
Sign
llture of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
ST
OF FLORIDA c. 1 -
STATE OF FLORIDA
COt
NTY OF r )�' ( „!(,I C� ,
COUNTY OF �
The
orgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this
day of 14:,,mak
this B day of A%4uS+ 2018 by
�
Name of
nally Knowncat
"s;4 cm�e
n "toon%�
Name of per making statementPers
Personally Known OR Produced Identificatio
Typ
of Identificat_
-r—
Type of Identification
Pro
ice
3
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Produc d
i r'
qen
LO... in
C 3 N T D
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Ny
(Sig
a re of Notary Public- Sc
o n
n
(Signatur of Notary ublic- State of Florida)
� cN
fission No.
�NX N� cnCom
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Commission No. (Seal)
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RE'
IEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8 2/17
III