HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10)a) 15 Permit Number:
RECEI''�D OCT 02 2015
SCANNED
Building Permit Application By
Planning and Development Services St. Lucie Count%
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: To Select from dropbox, click arrow at the end of line u,V% j
PROPOSED IMPROVEMENT LOCATION:
Address: 6375 S U S 1 , PORT ST LUCIE, FL 34952
Legal Descripfion: MODEL LAND CO'S S/D OF SEC 15 36 40 BLK 2 LOT 2-LESS RD R/W OF US 1-
AND LOTS 3 AND 6 AND LOT 8-LESS W 33 FT FOR RD AND CANAL R/W- IN NW 1/4 (MAP 34/15N) (39.00 AC)
Property Tax ID #: 341550100210004 Lot No.
Site Plan Name: h'Qi"f p Aa-epowo Block No.
Project Name: Metro A2P0305
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: III
Ground Work- In�tII 3� L-TE700 R?W_-- LcX-moo MeJ -Fo nl°w post
W_ ' Ilnsfull medki-M S +eSuppori' 1' bi n�+�U�FC�JAcabtn
kO ts7TripleXers -}o cr,o�x 12rtd9e.posl-
�I�r-�-r-a,�rm�i
CONSTRUCTION INFORMATION: III
E1HVAC UGasTank ❑Gas Piping UShutters
11 Electric 0 Plumbing Sprinklers 1:1Generator
Total Sq. Ft of Construction: 1 &0'50 _V_T S Ft. of First Floor: _
Cost of Construction: $ �i IX, 00 UtilitiesInSewer 0Septic
UWindows/Doors
URoof
Building Height:
-OWNER/LESSEE:-
CONTRACTOR:--
Name T-MobileiMetroPCS
Name: Daniel Ault
Address:1300 Concord Terrace
Company: Glotel
City: Sunrise State: FL
Zip Code: 34986 Fax:
Phone No.561-748-0302
Address: 3060 Orange Grove Trail
City: Naples State: FL
Zip Code: 34120 Fax:
Phone No. 239-776-5884
E-Mail: hvaldez@rgpartners.com
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: danault@olinwaynecompaanies.com
State or County License: ) l
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 14
DESIGNER ENGINEER:
Name:
* Not Applicable
d
MORTGAGE COMPANY: Not Applicable
Name:
Address: S
✓
Address:
City: n
Zip: �% OQ�1 Phone:
State:EU
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDE •
Name: F o f
_ Not Applicable
N u d
BONDING COMPANY: Not Applicable
Name:
Address: X
Address:
City:
1.
City:
Zip: Phone:
Zip: Phone:
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 (lowing building permit applications are exempt from undergoing a full concurrency review: room additions,
acce structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARRIN@ TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impro%:r%ntsstto your property. A Notice of Commencement must be recorded and posted on the jobsite
beforinspection. If you intend to obtain financing, consult with lender or an attorney before
commork or recording vour Notice of Commencement. -n
—Signature of Owner/
V
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _I IM A,,A , COUNTY OF ( A
The for oing instrumen wa acknowledged before me
thiday of lll��l
1 )1� � . 201�by
1 J O S2 l
(Name of person acknoggdging )
sa�I�s4rzWN letMA Ny�PepuoA
Commission No.Z ytsn6nl¢BIdIdX3
itzgm A4 R NOISSINN00 AW
Revised 07/15/2014
The forg .nstrument was acknowledgedbeforeme
this. IS day of � 20 )) by
VJAv(I{. L ;au I,T
(Na f perso cknowledging )
(Signature of Notary Public- State of Florida )
Known
,, I Commission No.6&V_?7/7
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