HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi p•GA- 2 -rrnL
ALL APPLICABLE INFO MUST BE COMPLETED FOkAPPI-I ATION TO BE ACCEPTED 1 /
Date: " �� SCANNED Permit:aumber. �SUZ•c9y/10
BY
St. Lucie County RECEIVE®
..�.
Building Permit Application AUG 77 2015
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 X Residential
PERMIT APPLICATION FOR: Building I i
PROPOSED IMPROVEMENT LOCATION:
Address: 16800 OKEECHOBEE RD
Legal Description: 136 38 THAT PART OF W 1/2 OF SEC LYG NLY OF SR 70-LESS CANAL RS/W AND LESS OKEE RD WIDENING AS IN O
Property Tax ID #: 3201-244-0039-000-8
Site Plan Name:
Project Name: 800642 TMO
Setbacks Front Back:
I DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Lot No.
Block No.
EQUIPMENT BADE AT EXISTING TELECOM FACILITY)
CONSTRUCTION INFORMATION:
JU
ttlona wo rK to Cifelerformed under tis permit —Check a apply:
❑H AC —Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing []Sprinklers ❑ Generator ❑ Roof
Total Sq. Ft of Construction:
Cost of Construction: $ U IDtp
S Ft. of First Floor: _
Utilities: Sewer ❑Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name -MOBILE
Name: DAN AULT
Address: 1300 CONCORD TERRACE
Company: GLOTEL INC
City: SUNRISE State: FL
Zip Code: 33323 Fax:
Phone No. &
Address: 3060 ORANGE GROVE TRAIL
City: NAPLES State: FL
Zip Code: 34120 Fax::
Phone No. glf - 77G - _97
E-Mail: I
Fill in fee slmp a Title Holder on next page ( if different
from the Owner listed above)
E-Mail: 94NrYnyii[e.,j" ++1.14
State or County License: CAL 13�� 7 L7
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
DESIGNER/ENGINE _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address* - I ei _� Address:
City. -L J j 'C3 —L State: — City: State:
Zip: Phone: S61—S�4G-0L�s Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Evans Properties Inc
Address: 660 Beachland Blvd Ste 301
City: VERO BEACH
Zip: 32963 Phone: _
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
_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 fir *pspection. If you intend to obtain financing, consult with lender or an attorney before
commencKe wdrk or recordine vour Notice of Commencement/) f / -
—Signature of Owner/
STATE OF FLORIDA p STATE OF FLORIDA pp
COUNTY OF { G t _ �24d` COUNTY OF I N lr �k li
The forgoing instrument was acknowledged before me
this? Qday of J 20 (�by
-0, " ' e ( 4-) ( +
(Name of person acknowledging)
Commission No.
Revised 07/15/2014
of Florida )
OR Produced Identification
The forgoing instrument was acknowledge d,efore me
this 21 day of o� 20 rLEL_ by
0C;,1k'eP ( A-C) lfi
(Name of person acknowledging)
(Signa r Notary Public- State of Florida )
MY CQ"r.*-\.;SSIGN O EE120314 `D
(mil}:-..F,;, „:;c�, rots `" Commission No.
r RTL:o:g'Jes:¢.:LL fz¢Co. d
OR Produced Identification
(Sea n'C.IISSION 0 EE120314
ENFIRES: Aug= 09, 2015
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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