HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED T /f
te: S1-148 Permit Number:
171
AD
- R, LE %WIL
Building Permit Applicati n AUG 15 2018
ing and Development Services
ng and Code Regulation Division Permitting Department
Virginia Avenue, Fort Pierce FL 34982
e: (772)462-1553 Fax: (772)462-1578 Commercial tPd6Hf!q .Cn-untYe. FL
PE I IVIIT APPLICATION FOR: Building SCANNED
PR..POSED.IMPROVEMENT LOCATIGN..
Address:
-19 03 iN-sTrvl0N bR. FT PIERCE FL 3�t95 1
Leg '1 Description: Lakewood Park -Unit 3-131k 22 Lots 25 and 26 (0.42 AC - 18,750 SF) (Map 13/11S) (OR4033-1922: 4034-
194r�� 4120-2141) j
Proplerty Tax ID #: 1301-603-0171-000-7 ,� Lot No. 25 & 26
Site (ir Ian Name: A'epAA—Z Block No. 22
Prod , ct Name:
(et acksI F n � • a9 t6ack: 2�• i� (Right Side- ; ) 0•05' ,Left Side:) 26-95' A ,,
DETr, ILED DESCRIPTION OF WORK: X
Install enclosed 38x40x10 detached accessory structure on footers/concrete
**NO ELECTRICITY**NO PLUMBING* e % J4 T vt a ty r� °T.
C01'VSTRUCTION INFORMATION: }
itionaiworKtobenerrormed under this permit— check all apply:
F1flHVAC _ Gas Tank ❑Gas Piping = Shutters Q Windows/Doors
�I Electric 0 Plumbing ❑Sprinklers FIGenerator Fv] Roof 3/12 Roof pitch
Tota',Sq. Ft of Construction: 1520 63 S . Ft. of First Flo r: 1520
Cost of
Construction: $ 9595.00�,��I lnl Utilities: Sewer Septic Building Height: 10
OW!
! 'LESSEE: ED MENTZ "
CONTRACTOR: JAMES PLAYER .
Name
Addr,
city:
Zip
Pho�e
E-M
Fill i
from
&bAlaM Mev fL
Name: JAMES PL AYEl2
ss: i 9Q 3 yjo-s'�vxo,n f Pir •
Company: CarpertijAnywhere, Inc
ll 0. PieuCe, rL 3g45I state: FL
ode: 34951 Fax:
No. (708) 803-6890
Address: PO BoX ��Z 0
City: c4TA RkE Y State: FL
Zip Code: 32091 ''- Fax: (352) 468-11.13
Phone No. (352) 468-1116
'lil: mentzed30@gmail.com
:fee simple Title Holder on next page ( if different
the owner listed above)
E-Mail: )bpermitsfl@gmail.com
State or County License: CBC1251995
If vale of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I _
�J
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: &10WI& Not Applicable MORTGAGE COMPANY: _ Not Applicable
N �me: MA`TTFtG1IJ ENhl1�I CEIQ-04Name:
A� dress: 1 l 6 0 PP-1VATE P-CA-10 Address:
City: DP_t'A lD Stater` City: State:
Zib: 32'I Zb Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
NAme:
Andress:
Zib: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
that no work or installation has commenced prior to the issuance of a permit.
County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
:. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In cTnsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in a cI ordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The ollowing building permit applications are exempt from undergoing a full concurrency review: room additions,
acc ssory 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
im 'Trovements to your property. A Notice of Commencement must be recorded and posted on the jobsite
bef re the first inspection. If you intend to obtain financing, consult with lender or an attorney before
con mencing work or recording your Notice of Commencement._ , 1_-.
as Agent for Owner
TE OF FLORIDA_
JNTY OF --�ha, e Ver
forgqing instrumentyvas acknowledged before me
lo day of 77� /Y 20d by
Fic"ItJ
Name of person making statement
finally Known OR Produced Identification
of Identificatt'io/[► to
1r0r4 Y(
lure of Notary Public- State c
ission No. FF 2L ?fC
of Contractor/License
STALE OF FLORIDA
COUNTY OF BRA DFp P—o
The for oing instrument was acknowledged before me
this for
of J U Ly , 2018 by
DAMES PLAyC-l-
Name of person making statement
Personally Known Identification
1,111
Type of IdentificationTaarPo°� Notary public State of Florida
Produced `� Burgln ,
or a
My Commission FF 912775
)F3cpires 08/26/2019
LAWRENCE RA A'`
NOTARY PUBLI CC
STATE OF FL OR DAr
Comm# FF17539
=-1— 4 414 4 PI 9Q
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mission No. 'Cl �(S(eal
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