HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICA71LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTE
Date: SCANNED Permit Number: ZQ
BY
S
t. Ltivip rnlinb
Building Permit Application RECEiVeC)
Planning and Development Servicesl
Building and Code Regulation Division JUL / 2 2015
2300 Virginia Avenue, Fort Pierce FL 1 34982
Phone: (772) 462-1553 Fax: (7i 1 2)462-1578 Commercial x Residential
PERMIT APPLICATION FOR�L Other
Ft.
Legal Description: SEE A
Property Tax ID #: 34U3-bUZ-U1 94-,UUO-3 Lot No.
Site Plan Name: St- Lude HospiceHouse Butterfly Garden
Block -No.
Project Name: St. Lucie Hospice ko6se Butterfly Garden
Setbacks Front Back: Right Side: Left Side:
[?ETAILEP,!DESCRIPTION:OF WOM
Install hardscapes, fountains� open roof peegola,,decorative butterny screenSir fehchng,',ret6inIng;WaII,
landscaping 6nd electric for three fountairfs. lrn,�4/11o',
CONSTRUCTION INFORMATION-.._ , ,�:,, I, I
Xlxa, *F
Additionalwork1totieverformed under this permit —check all apply: L
[—]ras Piping t-te Windomis/Diciors
HVAC -0 bas I ank Shu rs 0
'R] Electric P*Iumbin F ]Sprinklers Generator Roof
Total Sq. Ft of Construction: 340 Sq Open Roof Pergola
Sq. Ft. of First Floor:
Cottrof Construction: � E�Eoo Utilities: ED SewerEl
Septic Building Height:.
,OWN ER/LESSEE: C/O: Susan'R-. de Cuba CEO
CONTRACTOR:
Name Hospice Foundation of Martin & st., Lucie, Inc.
Name:.Simuel Hjdmeby
Company: Helmet . House construction LLC
Address: 1201 SE Indian Street
City: Stuart State:FL
Zip Code: 34997 Fax:
Phone No 772-403A81J1
Address: 9 00 20th . Place
City: Vera Beach State- FIL
Zip Code 1 3 2960 Fax: 77M13MB30
Phone No; ;T72�562 0866
E-Mail: sam@h6imethouseconstrucUon.com
E-Mail: gmartello@tchospire.org
Fill in fee simple Title Holder on next page If different
from the Owner listed above)
State or County. License: CBC11259322
ir vaiue at construction is.5z5uu or more, a RECORDED Notice of Commencem ntlsrequired.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNFR/_E_hdINffR_: —I Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: M5V ENGINEERING INC.
Name:
Address: 1835 20th STRM
Address:
City: —State:
City: VEROBEACH State: FL
Zip: 32960 Phone: m-5�mH
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: —Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or Installation �as commenced prior to the Issuance of a permit.
St. Lucie C6=7 makes no representaltion that is granting a permit will authorize the permit holder to build the subject structure
which is in con ict with any applicable Home Owners Association bylaws -and
rules, or 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 plahs, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applicailons are exempt from undergoing a full concurrencV review: room additions,
accessory structures, swimming plools, fences, wills, 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 younpaying twice for
improvements to your proipert�. 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
commencing work or recording vour Notice of Commencement.
S
Sigpaqre of Contractor/ er
_U&Tffse J
Signature of Owner/ Lessee/Agent
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-
STATE OF FLORIDA
STATE OF FLi
d-a-
COUNTY OF STAUCIE
COUNTY OF -
The forgoing InstrqTent was acknoldged
thls2Lclayof _a"tle
before me i
20 L5-by
The for g Instr= acknowledged before me
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thisr.diyof -20' by
a,
U
5CMtAel McbM'e,6A_
(Name of person ackno f) dti
(Rame of p�K! on _Icknowledging)
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(Slgnatui�eof Nota I Pulaft- State of Florida
(Signatureof Notary. Public-St.ate,o0forlda
Personally Known i---/ OR Produced Identification
Personally Kno v4 "45'
Type of Identification Produced �-,,�y A]
hYT%MMQ en (ff"yPUBLIQ ;;i�
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MY GON
Commissio EXPIRE
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VISSION # FF I STATE OF FLORIDA J
SZO&WmIAMW Comm# FIF053352 (Seal)
IlmdedflviludgeINDtaryServices
El Expires 9/11/2017
Revised 07/15/2014
REVIEWS
FRONT
ZONING
I
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
-MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW'
REVIEW'
DATE
COMPLETE
1A lt�
I
INITALS