HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^^^���
Date: SCANNED Permit Number:
St. Lucie County JUL .0 7
Building Permit Application
Planning and Development Services PERIv.
Building and Code Regulation Division St. Lucie Coui_y, Ft.
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 III
I.PROP.C)5ED-IMP-R(DVEME-NT,LOCAT[W-,'..
Address: 887 E. Prims Vista Blvd. Port St Lucie FI
Legal Description: River Park - Unit 3 - E 388.35 Ft of Track D as measured ALG The NLI of SD Track Map 34/225
Property Tax ID #: 3419-515-0001-0003
Site Plan Name: Port St Lucie Shopping
Project Name:
Setbacks Front Back:
Center
Right Side:
Left Side:
Lot No.
Block No.
OETAILED'DESCRIPTION OFUCIRK: ". • ;,: "' '::III
Dumpster Inclosure
:CONSTRUCTION'"NFORMATI'ON:
rtiona war to 6e errormed under this permit- check all apply:
❑_ HVAC Gas Tank ❑Gas Piping _Shutters ❑ Windows/Doors
❑Electric ElPlumbing []Sprinklers ❑Generator ❑Roof
Total Sq. Ft of Construction: S�Ftj of First Floor:
Cost of Construction �Q, �/ Utilities: nSewer ❑Septic Building Height:
:OWNER/LESSEE:-' �"
CONTRACTOR:
Name kfCf f LG
Name: Ren Ringe
Address: %•f/¢L/L'e;z P?
Company:. Bayview Construction Services
City: `✓7r,( State:,&
Zip Code: 3N 77 Fax: ,,�/v/ 7�7 3GGL
Phone No. S r �p I!O- 6 3 3P O
Address: 4826 SE Railway Ave
City: Stuart State: FI
Zip Cade: 34997 Fax: 772.288-1337
Phone No. 772. 283 -9300
E-Mail: Al ,ill /C.y 0 9 %9 461. Cow
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: dot@bayviewconstruction.com
State or County License: CGC 1520874
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Gs. sz
SUPPLEMENTAL CONSTRUCTION LIEN:LAW INFORMATION:
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
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 Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in co %ct 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
commencing work or recording vour Notice of Commencement.
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Hdfder
STATE OF FLORIDA , STATE OF FLORID,�4 f n
COUNTY OF r GwLIG COUNTY OF
The forggoing instrum__e,,PP..t was acknowledge before me The forgoing instrument was acknowledged before me
this G dayof ✓��% 20), by this S day of Z_ui1e 20 V
jV /ca14 t c
OW-Il--w6leT // 0 �2r1 Y1Q 2_
(Name of person acknow dging) (Name of person acknowledge
(Signature State of Florida - (Signature of Notary Public tate of Florida
r vp p(�
Personally Known P��I�'01Sjggt Personally Known OR Produced Identification -
Type of Identificati d _ 2In7 Type of Identification Produced
-zH'R1E5 2atahet2fti
Commission No. "hmn'F'a BO B°e�No�/Senftts
(Seal) Commission No.
.•. �'`-.z AiY r�11:.EISSIOYtFF931657
Revised 07/15/2014
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