HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/5/16 Permit Number: 1�D 'Cia1
RECEII'_�D JAN 06 2016
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 x Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line q N D T <
Address: 375 E Midway Road
Legal Description: WHITE CITY S/D 03-36-40N 261 FT of Lot 34-Less E 100 Ft and Less RD R/W
Property Tax ID #: 3403-502-0055-020-3 Lot No.
Site Plan Name: Block No.
Project Name: 68858 SBA Midway Road
Setbacks Front Back: Right Side: Left side:
_ an4 associated equipment cabinets
1:1HVAC
0GasTank
❑Gas Piping
LJShutters
Windows/Doors
ElElectric
0
Plumbing
Sprinklers
Ll Generator
0 Roof
Total Sq. Ft of Construction:
Cost of Construction: $ %)DoCJ
Sp1.- —Ft.� of First Floor: _
Utilities:Cn Sewer D Septic
Building Height:
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Name Verizon Wireless
Name: Brad Schehr
Address: 777 Yamato Road #600
Company: J Crompton Electric Inc
City: Boca Raton State: FL
Zip Code: 33411 Fax:
Phone No. 954-234-7070
Address: 1290 Old Congress Ave
City: West Palm Beach State: FL
Zip Code: 33409 Fax:
Phone No. 954-234-7070
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Christy@verticalpropertysolutions.com
State or County License: CGC1504970
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
Ir
DESIGNER/ENGINEER: _ Not Applicable
Name: Kimley-Horn
Address: 1920 Wekiva Way
City: West Palm Beach State: FL
Zip: 33411 Phone: 561-845-0665
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
MORTGAGE COMPANY:
Name:
Address:
City:
Zip:, Phone:
X Not Applicable
Not Applicable I BONDING COMPANY: X Not Applicable
Name: _
Address:
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 and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine work or recordine vour Notice of Commencement.
5
_ Signature of Owner/ Lessee/Agent Signaturetif ContractDrfticense Holder
STATE OF FLORIDA STATE OF FLORIDAn
COUNTY OF PALwt 908- 4- COUNTY OF K���1 4'k
The for oing mstrumgnt was acknowledged before me
this day of JGt✓% .20&by
u C_ C
of person acknowledging )
(Signatu f Nota ublic- SMte of Florida j
Personally Known V OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
The forggn g instrUkent was acknowledges before me
this day of _2 (AMIMIIr 20 ILP b
(Name of person acknowledging)
(2zAkdi�_ I -
(SignNtfre 6 Notary ublic- State of Florida )
Personally Known OR Produced Identification
Type of Identification Prod;:ce _
f FF tT Commission No.
My WIMISSION # SE16364
EXPIRES January 09. 2016
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