HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: — ? Permit Number: �Q i CA�OrO
-- Building Permit Application SCANNED
Planning and Development Services BY
Building and Code Regulation Division St Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxx
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: 4917 Palmetto DR Fort Pierce, FL 34982
Legal Description: INDIAN RIVER ESTATES -UNIT 05-BLK 3 LOTS 38,39 AND 40 (MAP 34/02N) (OR 2899-247)
Property Tax ID #: 3402-606-0014-000-4
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side:
Left Side:
Lot No. 38-40
Block No. 3
DETAILED DESCRIPTION OF WORK: III
30x50 Detached Garage on Concrete
****NO ELECTRIC - NO PLUMBING****
I CONSTRUCTION INFORMATION: III
E1HVAC U Gas Tank
11 Electric 1:1Plumbing
Total Sq. Ft of Construction: 1500
Cost of Construction: $ 17,247
Sas Piping
Sprinklers
Shutters ❑ Windows/Doors
Generator E] Roof 3/1 Z Roof pitch
S Ft. of First Floor:
Utilities:SewerElSeptic Building Height:_
OWNER/LESSEE:
CONTRACTOR:
Name FQri 11Qmed 0
Name: James Player
Address: Lea lop,
D (Dr.
Company: Carports Anywhere
City: erze State:a
Zip Code: 3 Ba7 Fax:.�7�P8 �ii�%
Phone No. 35b2- !o8_11 ff
Address: PO BOX 776
City: Starke State: FL
Zip Code: 32091 Fax: 352-468-1113
Phone No. 352-468-1116
E-Mail:
JyQrL ,CDYx-
Fill in fee simple Title Holder d next page ( if different
from the Owner listed above)
E-Mail: jbpermitsfl@gmail.com
State or County License: CBC1251995
IT value or construction is SZ5UU or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTkj4LIEN LAW INFORMATION:
Not Applicable I MORTGAGE COMPANY: -v NOt Applicable
Name: 14 IY r5QIUN1rI Name:
Address: l O PrIVVIK, V,00i Address:
City: UelaAu
Zip: 72 'ZD Phone
FEE SIMPLE TITLE HOLDER: �(
Name:
City: State:
Zip: Phone:
Not Applicable I BONDING COMPANY:
Address:
City: City:
Zip: Phone: Zip: Phone:
'v'NOt Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that 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 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
rnmrripnrinrs work or rprordine vour Notice of Commencement.
Signature of Owner/ Lessee ontractor as Agent for Owner
Signature of Con ractor/License Holder
STATE OF FLOKDr�A
STATE OF FLORIDA
1
COUNTY OF 1n0L i-An �fV e l
COUNTY OF F2Vae 4- )i'C4
The f7o-�rgoIng instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thisl dayof N20)M1Af- ,20-LK by
this Jg_day of Novewlbev' .20E by
Tame.S P[�zr
Name of person ma ' statement
Name of pers n king statement
�OR
Personally Known OR Produced Identification 1'
Personally Kn wn Produced Identification
Type of Ide tification pp _
Al 7Y,yAf6 1/I G 5&'
Type of Iden ication
Produced
inProduced
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(Signat of Notary Public- State of Flo ida)
(Signature o Notary Public- State of Florida)
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* * Expires June 21,
Expires June 21,2022OF
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REVIEWS
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VEGETATION
SEATURTLE
MANGROVE
COUNTER
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REVIEW
REVIEW
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REVIEW
REVIEW
DATE
RECEIVED
Z.
DATE
COMPLETED
Rev.8/2/17