HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/21/2016 Permit Number:
R E C E I'." D MAR . 12016
Building Permit Application SCANNED
Planning and Development Services BY
Building and Code Regulation Division St. Lucie Count,
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Alteration
PROPOSED IMPROVEMENT LOCATION: _
Address: 7131 S US HWY 1, Port St. Lucie FL
Legal Description: 22 36 40 BEG AT SE COR OF NE 1/4OF NW 1/4 RUN S 27 DEG 38 MIN E 210 FT TO N LI
OF RIO MAR DR, TH S 62 DEG 22 MIN W 30 FT, TH N 27 DEG 38 MIN W 225.83 FT, TH N 89 DEG 49 MIN W 555.72 FT M/L, TH N 00 DEG 07 MINE 800 FT, TH S 89 DEG 49 MINE
Property Tax ID #: 3422-211-0010-000-6
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
DETAILED DESCRIPTION OF WORK;,
1. Repair Ceiling Tiles 2. Cap 2 Waterlines and Cap Drainline
CONSTRUCTION INFORMATION:
OHVAC Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction: 900
Cost of Construction: $ 520.00
Lot No.
Block No.
I IIL —wcl.n au GIJIJVr.
Piping Shutters ❑ Windows/Doors
ars F]Generator Roof
S Ft. of First Floor: 1160
utilities.. Sewer Septic Building Height: _
OWNER/LESSEE-
CO NTRACTO Ri
Name Port St Lucie Plaza I LLC
Name: Roderick Waller
Address:112 Phylis Ct
Company: Sunrise City CHDO, Inc.
City: Elmont State: NY
Zip Code: 11003 Fax:
Phone No.
Address: 800 Virginia Ave Suite 61
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 772-907-0420
Phone No. 772-201-2850
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: rodwallerl@gmail.com
State or County License: CGC1515114
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
TA[ C
Sl)PPLEIVIENONSTRUCTION wI EN LAW=INEORMATION
-
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:
Name:
_Not 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 Count
yy 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 rec®rdine vour Notice of Commencement.
—Signature of Owner/
STATE OF FLORIDA
COUNTY OF 3h • L Uc\�
The forgoing instrument was acknowledged before me
this L day of `M4 C 20 \by
STATE OF FL I�A
COUNTY OF lr vc\
The forgoing instrument was acknowledged before me
thisa� day of 'f'^a{ 20 ,� by
�O C��'lci. Lf1d�."�• � � D d ¢ C � c, lc V'd,. � �'C.-i
(Name of person acknowledging ) (Name of person acknowledging )
Notary Public -State of Florida )
Personally Known
Type of Identificat
Commission No. I
Revised 07/15
Boov,
(Signature of Notary Public- State of Florida )
Known
Type of
#. EEt I Commission No.
OR Produced
Notary Pu Iic state of Flonaa
Ny comm.%'c 4 Dec 16, 2016
Commission # EE 858761
o,,,,ml Notary Assn
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