HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/5/16 SCANNED Permit Number: 1607-0157 row6✓C.
BY % o oa(a
St. Lucie Countv
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)462-1578 Commercial X
PERMIT APPLICATION FOR: ` '' - ` o----r `-'" —'
To Se ec from roobox, cllc rrow at the end of line
PROPOSED IMP
Address: 14191 Rangeline Road Port St Lucie FL 34987
Legal Description: sp-2 CY7?'76ae_y0 2R6,O.&'%r d/+4b
Property Tax ID #: 4233-111-0001-000/6
Site Plan Name:
Project Name: City West
Setbacks Fri
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK`
installation of a respect bridge (ice bridge) from shelter to tower
V�C+C&VMS
ry / Lot No.
/_t Block No.
No Svtcv� v±vim
fining $ Development.
services
AUG 10 2016
I CONSTRUCTION INFORMATION: I
❑HVAC U Gas Tank
Piping LJShutters
_Electric _Plumbing I,ISprinklers I (Generator
Total Sq. Ft of Construction: S Ft. of First Floor: _
Cost of Construction: 0 L/ s low Utilities:12Sewer ❑ Septic
❑Windows/Doors
❑ Roof
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.
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: kcardck@carrickcontracting.com
State or County License: CGCO55116
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Name; AmecFaster & wheeler Ewironment&infrastructure inc
MORTGAGE COMPANY:
Name:
X Not Applicable
Address: 1075 Big Shanty Road Suite 100
Address:
City: Kennesaw State; GA
Zip: 30144 Phone: 7704213400
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 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 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 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 I.
_ Signature of Owner/
STATE OF FLORInA
COUNTY OF lz -_ 1 t(tiP
The for oing instru ent was acknowledged before me
thisMayof ` c A-c ,k . 2016( y
na \ �a
(Name of person ac no ledging I
Notary Public- State
Personally Known
Type of Identiffcat
Commission No.
Revised 07/15/2014
OR Produced Identification
STATE OF FLORIDA`... TDIP-0.Gh
COUNTY OF
The forgoing instrument was acknowledged before me
this LO day o20 (p by
�_S��YYlGG�
(Name of person acknowledging I
NotaryPudic Sta I?cfM0
Katrina J Slay FIB My Commissbn 07207e
� 1 Euc_�
of N ary Public -State of Florida I
Known /OR Produced Identification
No. JAC&RIII. MCNNIN
Notary Public - State of Florida
My Comm. Expires Jul 30. 2020
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