HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST COMPLETED FOR APPLICATION,,'
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1 December 23, 2015 �7
Date: Permit Number: Ljp 01- 01 / lP
L��„� RECEIVED
Buildim Permit Application JAN -1-3- 2016
Planning and Development Services SCANNED
Building and Code Regulation Division BY
2300 rtrginia Avenue, Fort Pierce FL 34982 St. Lucie Count%
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shed DC
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Address: 13827 South Indian River Drive, Jensen Beach, FL 34957
Legal Description: LAKE MANOR PARK COOPERATIVE- A RESUBDIVISION OF A PART OF
SECTIONS 9 AND 10 TOWNSHIP 37 RANGE 41 AS SHOWN IN OR 861-1051 (AS PER FS 719.114)
Property Tax ID #: 4.fU $ U S- O 6 0 b- o n o Lot No.
Site Plan Name: Block No.
Project Name: Storage Shed in back lot
Setbacks Front Back: Right Side: Left Side:
1 DETAtiED DESCRIPTION OF `WORK
Install a prefabricated storage shed ( 12 x 24') in back lot.
i CONSTRUCTION INFORMATION y Y , '
ISDfiona wor to e e orme er is permit at a
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�HVAC Gas Tank ❑Gas Piping Shutters WmDows/Doors
Electric F� Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: 288 Sq. Ft. o Floo : 288
Cost of Construction: $ 5.300.00 Utilities:Sewer _ Septic Building Height: 12
OWNERlLESSEE w
r' GQNTRACTOR_, Lr.
Name Lake Manor Properties Inc 'Name. Dan Shawver
ADDress: 1111 SE Federal HWY Ste 100 Company; DS General Contrators Inc
City: Stuart State: FI_ ADDress-' 2032 SE Gillen Ave
Zip Code: 34994 Fax: (722) 288-0175 City: ! Port St Lucie State:_
Phone No. (772) 334 8900 Zip CoDe_ 34957— F - 772 3350375
E-Mail: advantagepm@bellsouth.net Phone No. 772 335 0035
Fill in fee simple Title Holder on next page ( if different E-Mail: info9dsgeneralcontractors„ & 11M
from the Owner listed above) State or County License: CGC 015943
If value of construction is $2500 or more, a RECORDEDNotice of Commencement is required.
SUPPLEMENTAL.CONSTRUCTI IEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 ofthegranting of this requested permit, I do herebyagree that 1 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 recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consillit with lender or an attorney before
commencing work or recording vour Notice of Commencemen .n
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_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA STATE OF FLORIDg�
COUNTYOF mdrf' r'_ COUNTY OF
The forggoing instrument was acknowledged before me The forgoing instru ent was acknowledged befor
this ggayof UCLcn u�, 201(o by this _D�day of 20 10 by
C t^a s i n k+� DEcG.st. otl i Z)4 V
(Name of person acknowledging) (Name of person acknowledging)
�i1Mz1 �� .t.t2�ti
(Signature of Notary Public- State of Florida )
Personally Known / OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
AMYFELDMAN
4SM000. MISSIONtFF220673
(Signature of N?Ory Public- State of Flof cia )
Personally Known 00 Rto ced Id�ntific
Type of Identification Produce
Commission No. v (Seal)
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