HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL f APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
E 'I: 09/24/2018 Permit Number:
Building Permit Application Q' ",
ing and Development Services ?Q18
ng and Code Regulation Division `Rl�tt1.a9
Virginia Avenue, Fort Pierce FL 34982 1'r'P C unt, ent
e: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PER
IT APPLICATION FOR: Shed DCA
PROjlpQ,
ED'IIHIPROVEMENT LOCATION ry
i
4..
aueie Addr 'eOyanihf
Legal iDescription. 8 3540 PART OF SE 114 OF NW 1/4MPDAF: FROM INT W LI ANGLE RD AND NLI OF ORANGE AV, AS SHOWN IN PI, BK 7-12, RUN WON N LI ORANGE AV
547.02 F FOR POB, TH N 173.64 FT, TH W 326 FT, TH S 25.71 FT, TH E 81 FT, TH S 147.93 FT, TH E 245 FT TO POB-LESS S 9 FT AS IN ORD TAKING CA 982-6-05- (0.97 AC) (OR 1347-1516)
Prop Irty Tax ID #: 2408-243-0003-000-6 Y Cb
— b05 — Q Lot No.
Site �an Name: Block No.
Prole Name:
Setb 41os Front Back: Right Side: Left Side:
DETi ;Itt DESCRIPTION OF WORK Y f A
Install prefabricated manufactured shed. Install tie downs per engineering provided.
Addiitional work to be ertormed under this permit — cnecK all apply:
'9 HVAC 13 Gas Tank Gas Piping _ Shutters
Electric L1 Plumbing Sprinklers Generator
Totals, q. Ft of Construction: Scl. Ft. of First Floor: _
Cost pf Construction: $ Utilities: Sewer []Septic
QWindows/Doors
Roof Roof pitch
Building Height:
�ow�N
ER/LESSEE q ,
CONTR CTOR
A
Y
Name
Seminole Mobile Park LLC c/o Riverstone Communities
Name: David "Harley" Van Ginhoven
Address.
6400 Telegraph Rd. Ste 2000
Company: D C Construction & Company, Inc.
City:1
Bloomfield Township State: MI
Address: 1916 21 st Ave.
Zip
Mode: 48301 Fax:
City: Vero Beach State: FL
Pho
a No. (772) 293-0069
Zip Code: 32960 Fax: (772) 567-4237
Phone No. (772) 360-8571
E-Mall
il: kcconti@rivstone.com
Fill i
E-Mail: harley@ibuildwithcare.net
fee simple Title Holder on next page ( if different
fro
the Owner listed above)
State or County License: CGC1507644
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
r
SUPPL"EMENTAL`CONSTRUCTION
LIEN LAW INFORMATION
DEStiGNER/ENGINEER:
Narr'e:
X Not Applicable
Seminole Mobile Park LLC do Riverstone Communities
MORTGAGE COMPANY: X Not Applicable
Name: David "Harley" Van Ginhoven
eSS: 3318 Orange Ave., Fort Pierce. FL 34947
Address: 6400 Telegraph Rd. Ste 2000
Add
Bloomfield Township State:
City.
City: Vero Beach State:
Zip:
Phone
Zip: Phone:
FEE
Na
SIMPLE TITLE HOLDER: X Not Applicable
e:
BONDING COMPANY: X Not Applicable
Name:
Address:
Add
'less: 1916 21st Ave.
City:
City
Zip: Phone:
Zip:
it Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certi y that no work or installation has commenced prior to the issuance of a permit.
St. Luc 'a County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which s in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
struct 're. 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 acc'I�dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fo Towing building permit applications are exempt from undergoing a full concurrency review: room additions,
access ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impr vements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befo 'e the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commiencing work or recording our Notice of Commencement.
I0
Si n Iiture of Owner/ Lessee/Contractor as Agent for Owner Signa ure of Contractor/License Holder
STATE OF FLORIDA II STATE OF FLORID
Vk,,,,,_.
COUNTY OF COUNTY OF
The IL �l rgQing instru —Ant was acknowledge before me
this( day of '0J 20_U by
il Name of person making statement /
, Per �nally Known OR Produced Identification v
Typ� of Identificatio
Produce ffi W %ZD
The forgoing instrument was acknowledge before me
this6)i o day of N�W 20 % by
-10 1Jv
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
(lIt to �§'o '"IP-StateofRorida (Si torefNotaPublic-Stat Sige , �o Florida_),
mission # GG 167258
LASNANNA INGRAM
�� " ��� My om .Expires Dec 11, 2021 Commission No. �'�""Y P6°�:'. Notary P (s�ai)3tate of Florida
CO mI5510n O. ! B oughNalonalNol;ryAssn. # * My Comm. Expires Dec 20, 20'
:N'9.`c Commission # FF 1772,
RE I IEWS FRONT ZONING SUPERVISOR PLANS VEGETA Ib1V SEA TURTLE' ` MANGROVE
�I COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RE I=1VED
DATE
COMPLET
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