HomeMy WebLinkAboutBUILDING PERMIT APPLICATION4
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a
Date: 9128/2015 Permit Number: SD 1 b y S 7
RECEIT7D SEP 2 g 2015 SCANNED
Building Permit Application By
Planning and Development services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial xxx Residential
PERMIT APPLICATION FOR: Alteration
PROPOSED IMPROVEMENT LOCATION.,'
Address: 10690 S US Hwy 1 Port St Lucie, FL 34952
Legal Description: St Lucie Gardens 12 37 40 Blk 4 10690 S US Hwy 1
Property Tax ID #: 3414-501-5001-250-7
Site Plan Name:
Project Name: Southport Dental - Dr. Cook
Setbacks Front Back:
Right Side:
Left Side:
NZ,
Tenant Alterations . ;N4erio-- Cxe�-e_ CS)OJ4,-
Lot No.
Block No.
�CONSTRUCTIOW INFORMATION:
rtiona wor to _e_p_e�
orme un
ert is perrmt
ec a
app yc
❑✓ HVAC
Il
Gas Tank
❑Gas
Piping
_ Shutters
❑
Windows/Doors
✓Electric 0
F]
Plumbing
Sprinklers
Generator
Roof
Total Sq. Ft of Construction: +/-1850
First Floor: +/ 1850
Cost of Construction: $ 38,560.00
Utiliti
s: S wer L-1 Septic
Building Height: 1
0 NERAESSEE '
GONTRACfiOR:
Name Michel G. Cook DMD PA
Name: Robert P. Cemorest
Address: 10690 S. US 1 Suite A
Company: Demorest Construction Group Inc.
City: Port St. Lucie State: FL
Zip Code: 34952 Fax:
Phone No.
Address: 800 SE Indian Street
City: Stuart, State: FL
Zip Code: 34997 Fax: 772-220-0227
Phone No. 772-220-0065
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: bodemo@demorestconstruction.com
State or County License: CBCA52954
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
s
I;SUPPLEMENTALCONSTRUCTION 'LIEN l'AW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Joseph P. McCarty. Architect, Inc. Name:
Address: soo East Osceola street Address:
City: swan State: FL City: State:
Zip: Phone: 772-257-6735 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 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 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 apq posted 9,n the jobsite
> w before the first inspection. If you intenoto obtain financing, consglith lenderan atto/fifi?Y before
of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF g*. L-u-Ne-
STATE OF FLORIDA
COUNTY OFSt.LaeIe
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 56''t'day of 5-egi-g_m . 20 -!!!by this " day of September 20 15 by
M I c{ (_A e m k— Robert P >rnorest
(Name of person acknowledging I (Name
%of person acknowledging
)
(J_Z� (�lLi�(/i-i
(Signature of Notary Public- State o lorida) (Signature of Notary Public- S e of Florida )
Personally Known /A OR Produced Identification Personally Known xxx OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.
Revised 07/15/2014
Commission
maxpe `- Nofery Pum
?; j% Veronica L
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VEGETATION
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