HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL AP 11LICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I il$ 6 Permit Number:
SCANNED
�� �� RECEIVED
St. Luce �� Ift
AUG 15 2018
:�� Building Perm Appt�cation
Planning and Development Services ST. Lucie County, Perm=nq
euildin and Code Regulation Division
2300 U 1rginia Avenue, Fort Pierce FL 34982
Phon' (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERM T APPLICATION FOR: To Select from dropbox, click arrow at the end of line �Oc
PROPOSED IMPROVEMENT LOCATION:.
Addressi. 10301 S INDAIN RIVER DR
{ HEERMAN'S S/D THAT PART OF N 100FT OF LOT 1 LYG E OF ELY RR RLI
Legal Description: MJ
Proper Tax ID #: 3529-701-0001-000-2
Site PIE n Name:
Proje Name:
Setbacks Front Back:
II
DETAILED DESCRIPTION OF WORK:
a � �
Right Side: Left Side:
Lot No,
Block No.
CONSTRUCTION :INFORMATION:
Additl na wor to e e orme under this permit — check a app y:
VAC F] Gas Tank ❑Gas Piping _ Shutters a Windows/Doors
Zi
i lectric 0 Plumbing Sprinklers FI Generator E]Roof Roof pitch
Total q. Ft of Construction: SC . Ft. of First Floor:
O
Cost I Construction: $ �S Utilities: Sewer Septic Building Height:
OWI''ER/LESSEE:
CONTRACTOR:
Namell t
Name: CHMSQRIENDEAU
AddreLl s: \ OW'\ S w _;W_rem
'Company: XTR E ELECTRIC SERVICES ONC
Address:
City: II 1 lLr State:
Zip dole: q �Z Fax:
'City: State: FL
PhoneNo. �® Z Q 3
Zip Code: 34982 Fax: 772-353-5078
E-Mall:
Phone No. 561-333- 19
Fill in simple Title Holder on next page ( if different
E-Mail: ARIEND U@YMAIL COM
I'fee
from the Owner listed above)
II
State or Coun License: EC130 50
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL
CONSTRUCTION LIEN LAW INFORMATION: .
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name
Name:CHRIS RIENDEAU
AddrE
s.
Address:
City:
11
State:
City: State:
Zip: ill
III
Phone
Zip: Phone:
FEE SI
PLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name
Name:
Address:
Address:
City: I
City:
Zip: I Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify I hat 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
structur IeI. 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,
accessoryy 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 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
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Signat
re of Owner/ Lessee/Contractor as Agent or Owner
Signature of Contractor/License Holder
STATE
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COUNTY OF ORIt rrSTATE OF FLAD V � �ClG�1
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The fc
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The f r oing instr ent was cknowledge fore me
this
day of 20 by
this I day of 2o� by
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Name of person making statement
Name of person making statement
Persoplally
Known OR Produced Identification
Person nown OR Produced Identification
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(Sig
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(Signature of Not Public- State of Florida)
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Rev. W/17 N