HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 815/16 SCANNED Permit Number: 1607-0157 TOWKC
BY q fag- -oa( 3
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) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: h L �, r��
I rnur67Jtu IlylrKUytIVItNI LULAIIU.INt
Address: 14191 Rangeline Road Port St Lucie FL 34987 - n
Legal Description: 3� r lief qgo o,l//�1
Property Tax ID #: 4233-111-0001-000/6 / 42d4W
,g tev, W (_o/)L* Lot No.
l
Site Plan Name: Block No.
Project Name: City West
Setbacks Front Back: Right Side: Left Side: A �^Ua
DETAILED DESCRIPTION OF WORK; Planning & Develonmenr
installation of generator and pad for generator
AUG 10 2016
CONSTRUCTION INFORMATION:'
Aclaitional work to be erformed un ert is permit — cneck all apply:
❑HVAC Gas Tank ❑Gas Piping Shutters ❑ Windows/Doors
Electric 0 Plumbing []Sprinklers Generator Roof
Total Sq. Ft of Construction: An S Ft. of First Floor:
Cost of Construction: .J" UUtilities: �Sewer ❑Septic Building Height:
OWNERAESSEE:
'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: 349884y Fax: G
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: kcar(ck@cardckcontracting.com
State or County License: CGC055115
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION, LIEN LAW INFORMATION: .
DESIGNER/ENGINEER: x Not Applicable
Name: Amec Foster & Wheeler Environment & infrasWctum inc
Add resS: 1075 Big Shanty Road Suite 100
City: Kennesaw State: GA
Zip: 30144 Phone: 770-421-3400
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
x Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: X Not Applicable
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
St. Lucie Countmakes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conAct 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 attorrry before
commencing work or recording vour Notice of Commencement. I II
Tlkoff..--_
s
_ Signa4 re of Ow en rT seg` gent
Signature of Cont or/L s Holder
STATE OF FLORIDA
STATE OF FLORID
COUNTY OF �}— (,(,1 CA (
COUNTY OF 1�11rn ��OECl()n
The u
ing instr ent was acknowledged before me
for--
The forgoing instrument was acknowledged before me
this
dlIay of S 20 l�by
this 10 day of Pcy sby Sa 20 1 b by
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(Name
�of�person acknowleA ing )
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(Name of person acknowledging )
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( ignatu a of Notary LIC- ate of Flori )
(Sign' ture of ary Public -State of Florida )
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`COR
Personally Known Produced Identification
Perso Ily Known V-1`OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No. eal� ry
eraota public State of F1
dda s a 1, Notary Public - IN
sion ? ,..•^r dACLYNN E. 2,, YFl
to 8 u{ Florida
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Commission * FF980222
")'qpW Expires 11/202017 bw4t; My Comm. tapir.. •......... II
Revised 07/15/2014 ' ,4L!t: BWedtlrcou9bW108a1W&fyAsso.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
/
INITIALS