HomeMy WebLinkAboutBUILDING PERMIT APPLICATION4 �1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED L�
Date: October 29, 2015 Permit Number:
RECEIVED DEC 15 2015
NEW Building Permit Application SCANNED
Planning and Development Services BY
.. LUCIA Ci®Untt.
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Modular office
Address: 2498 Edwards Road, Fort Pierce, FL 34982
Legal Description: 213540 S 395.97 FT OF IN 219.98FTOF W IQ OF W 1R OF SW 114 OF SW 7/44ESS S 40 Fr FOR WAND LESS W SOFT AND LESS BEGAT PT OFINT OF ELY RIW OF
S 25 ST AND NLY RW OF EDWARDS RD, TH NU DEG 70MIN 51 SEC W 20 Fr, TH S 46 DEG 06 MIN" SEC E 28.81 Fr, TH S 89DEG 57 MIN 23 SEC W 20 FTTO POB(1.385 AC) (OR 3386-Mll)
Property Tax ID #: 2421-333-0001-000-9
Site Plan Name: Carroll Collins
Project Name: Carroll Collins 10
Setbacks Frori� Back: Right Side' Left Side:��
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: III
Modular Sales Office, leased from Williams Scotsman. Water, sewer, electric connections,
concrete work, handicap parking area and sidewalk.
CONSTRUCTION. INFORMATION: III
onaiworKiooe
errormeu
unuerEmspermit—
❑Gas
cnecKan
apply:
HVAC
Gas Tank
Piping
_Shutters
Windows/Doors
Electric
❑✓_Plumbing
Sprinklers
11 Generator
0Roof
Total Sq: Ft of Construction: _
Cost of Construction: $ 7,250
S Ft. of First Floor:
Utilities:SewerE]Septic Building Height:
OWNERAESSEE;
CONTRACTOR:
Name Carroll B Janet Collins
Name:
Address: P.O. Box 4114
Company:
City: Fort Pierce State: FL
Zip Code: 34948 Fax: 772-461-3887
Phone No. 772-461-2245
Address:
City: State:_
Zip Code: Fax:
Phone No.
E-Mail: Collinsbonding@aol.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not ApplicaDle MORTGAGE COMPANY: _ Not Applicable
Name: Steve Capper Name: Hadwr Community Bank
Address: 7450 South Fedeml Highway Address: 1558e sw wareetd Blvd
City: Port St Lucie State: FL City: tndiantown State: FL
Zip: 34952 Phone: 772-336-2933 Zip: 34956 Phone: 772-489-3113
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
x Not Applicable
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
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SL fade COUNTY OF
The folgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this _day offiF FUGAL-. 20 LS--by this _ day of . 20 _ by
CNMneM. Perez (Name of person acknowledging)
NOTARY PUBLIC
,STATE OF FLORIDA
(Signatureyof Not Public- St ri&olres 3113/2Df9 (Signature of Notary Public -State of Florida )
Personally Known x OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
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