HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: it 0 O1 - Mae
BY
gggjig�&g St. LucieCounty RE�'"�"a�l ��
r
Building Permit Application JAN 2 2 W6
Planning and Development Services
Building and Code Regulation Division PERM14TING
2300 Virginia Avenue, Fort Pierce FL 34982 . St. Lucie County, FL
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
Address: 5050 S 25 Street Ft Pierce FL 34981
Legal Description: WHITE CITYSI NW408150 FTOF E290 FT OF WW5"OF WMOF LOT 52-LESSWO"AND LESS MIDWAY RD R (1.WAC)(MAP 241 )(OR 17W4:247&1497)
Property Tax ID #: 3403-502-0096-010-9
Site Plan Name: Cheyne Prof Complex
Project Name: ,neyno
Setbacks Front Back:
7'x5'x8'-2" Monument Installation (relocation)
INI
Left Side:
E1HVAC U Gas Tank ❑Gas Piping UShutters
11 Electric 0 Plumbing / ^❑SSprinklers Generator
Total Sq. Ft of Construction: l0 -6 2 Sq. Ft. of First Floor: _
Cost of Construction: $ 7700.00 Utilities: [] Sewer O Septic
Lot No.
Block No.
❑Windows/Doors
Roof
Building Height:
_OWNER/LESSEE:
CONTRACTOR. •; , ,' • °
Name cheyne Professional Complex
Name: Gerald Foland
Address: 5050 S 25 St
Company: Baron Sign Manufacturing
City: Ft Pierce State: _
Zip Code: 34981 Fax: 772 468 7929
Phone No. 772 468 8891
Address: 900 13 Street West
City: Riviera Beach State: FL
Zip Code: 33404 Fax: 561 848 2270
Phone No. 561 721 0658
E-Mail: cheynechiro@hotmai.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: permdept@baronsign.com
State or County License: ET0000178
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
�SURPLEMENTAL�xCO,NSTRUCTION�LIEN�CgW�INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not
Name:
Applicable
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 ermit 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 n)0st be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, lzrsult with lender or an attorney before
commencing workubr n4cirdlne vour Notice of Commencem /1 _
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF s wca
The for oing instrument was acknowledged before me
this day of , 20 /6_.by
L�Bi &--a % 9l6r)i CL
(Name of person acknowledging )
L=__
(Signatu f Notary Public- State of Florida )
Personally Known x
Type of Identification
Commission No.
Revised 07/15/2014
OR Produced Identification
My W[y MISSION #FF1855t
EXPIRES December 28, 201
eA
STATE OF FLORIDA
COUNTY OF se wae
The forgoing mptryment was acknowledged before me
this,2P day tl 20,[4,_by
qng L'I 7-o(.ar2.
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
finally Known x OR Produced Identification
of Identification Produc d
No. �s �f�MMISSION #FF1
Lnr ......., o
'.?o, Fd;= EXPIRES December 28,
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