HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MusT BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: (�V f ( /�
SCANNED
Number: -L_U00O'-
RECEIVFU
BY
St. Lucie County APR ,2 4 2019
11
Building Permit ApplicatioriPefSttLuciacountvent
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
PERMITTYPE: SLAB
PROPOSED IMPROVEMENT LOCATION:
Address: 6017 BUCHANAN DRIVE, FORT PIERCE, FL. 34982
Property Tax ID #: 3402-603-0042-000-0
Site Plan Name: WOODDUDE
Project Name: LONGTIME
DETAILED DESF 19 Fg
SLAB 30' X 6 AND ON WEST SIDE
4" THICK. AREA TERMITED TREATED
CONSTRUCTION
X 30o CONCRETE WILL BE 2,500 PSL WITH FIBER
AREA
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
- - 6
Cost of Construe___..- . - ODO ` Utilities: _ Sewer _ Septic
Lot No. 67, 68, 69
Block No. 6
A MIN OF
�--4
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name GREGORY WILKENS
Name: JOHN RODGERS
Address: 6017 BUCHANAN DRIVE
Company: JOHN RODGERS CONCRETE
City:.. FORT PIERCE -_ State: _
Zip Code: ' 34982'" Fax:
Phone No: . J
Address: 355 PALMS AVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772465-3827
Phone No 772-201-8165
E-Mail- - -
Fill in fee simple Title Holder on next page ( if different
z. from the Owner listed above)
E-Mail RODGERSCONCRETE@GMAILCOM
State or County License' 19377
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is, required._
r
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 Countv 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 concurreniy 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 IMPROVEMEAITS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SIITE.BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
signatu Owner/ ssee/Contracto�Agent for Owner
Sign ure of Contea.ct r/Dcense Ho
STATE OF FLORIDA
STATE OF FLORID%�11-,,
COUNTY OF ,�,
COUNTYOF e�itL nia_
The fo Ding instr i ent was acknowledge before me
The rgoing instrument was acknowledged efore me
th day of 20 by
thi day pof Z0� y
Yoh
Name of Ison making statem6ht.
Name of pion making staternei4t.
Personally Known OR Produced Identification _
Personally Known . OR Produced Identification
Type of Idea -fication
Type of Identification'
Produced
Produced
( \Fign ure f Notary Public - St a of Florida
gnature of Notary Public- fate of Florida
Commission No. (Seal)
Commission No.MING
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