HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/5/16 S(;ANNED Permit Number: 1607-0157 TOWO&
BY St. Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 467,.1578 _ Commercial X ( JR&derltial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
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Address: 14191 Rangeline Road Port St Lucie FL 34987
Legal Description: 34e-&i 4�?Te&9:? I79O 1-110&7
Property Tax ID #: 4233-111-0001-000/6
Site Plan Name:
Project Name: City West
Setbacks Front Back:
Right Side:
Left Side: AV
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: 1 ; Planning & Development
installation of a pre -fabricated shelter for new tower site
AUG 1,0 2016
CONSTRUCTION INFORMATION:
OHVAC 0 Gas Tank Gas Piping UShutters Q Windows/Doors
Z✓ Electric 0 Plumbing Sprinklers Generator Roof
O
Total Sq. Ft of Construction: o S Ft. of First Floor: .
Cost of Construction 1 Utilities: Sewer Septic Building Height: _
OWNER/LESSEE:
CONTRACTOR:
Name city of Port St Lucie
Name: Thomas J. Carrick
Address:121 SW :Port St Lucie Blvd
Company: Carrick Contracting Corp
City: Port St Lucie State: FL
Zip Code: 34984 Fax:
Phone No.7��,_);)!
Address: 1450 Kinetic Road
City: Lake Park State: FL
Zip Code: 33403 Fax: 561-844-5641
Phone No. 561-844-5322
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: kcar(ck@carrickcontracting.com
State or County License: CGCO55115
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTIONLIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name: AmecFoster & Wheeler Environment &infrastructureinc
MORTGAGE COMPANY:
Name:
x Not Applicable
Add res5: 1075 Big Shanty Road Suite 100
Address:
City: Kennesaw State: GA
Zip: 30144 Phone: 770-t21.3400
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY:
Name:
x 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 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. I
// 1.Q r //" le- I I d
_ Signature of Owner/ L�&fee/Agent
STATE OF FLORID/
COUNTY OF JF. Ut6
The forgoing instrument was a knowledged before me
this 2 day of 20 N,�,b
Notary Public State of Florida
rKatrina J Slay
(Name o w k g{Pg ot2
(Signaturd of Notary PuV ic- $tate of Florida )
Personally Known `
Type of Identification
Commission No.
Revised 07/15/2014
OR Produced Identification
(Seal)
STATE OF FLORID�IM � COUNTY OF
The forgoing instrument was acknowledged before me
this 10 day of� 204P by
(Name of person acknowledging )
V ./
Pers ally Known — OR Produced Identification
Type of Identification Pr
JACLYNN E. MCNEVIN
Commission No. =i° pe ` Notlic - State of Florida
•ii Commisslon 8 FF980222
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�•„ ..... ° 90011111 through National Nolary Assn
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