HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONc
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J��^ (�
Date: 9/8/2016 SCANNED Permit Number: f! W O ` Ol"`-t��%
D
BY
s St. Lucie Countv OOD
• Building Permit Application Clsli
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Renovation
,PROPOSED IMPROVEMENT.LOCATION.
Address: 6971-8-CS HWY 12�_
Legal Description: AETNA PARK S/D ELK B LOTS 10 AND 11 AND LOTS 1 AND 2 OF ELK
Property Tax ID #: 3410-701-0006-000-2
Site Plan Name: Laundry Room
Project Name: Renovation
Setbacks Front Back:
Right Side: Left Side:
UtIHILtU'UtYL.KIF'IIUN,UI WVKK.
- Add Covered Back Porch to Laundry Roof
- Add Electrical Outlets
- Extend Plumbing Drains
Lot No.
Block No.
mCONSTRUCTION''INFORMATION
itiona wor to e nerrormea
unciertnispermit—check
all
apply:
0HVP
1:1Gas
Tank
E]GasPiping
_Shutters
❑Windows/Doors
Z✓ Electric 0
Plumbing
[]Sprinklers
Generator
W1 Roof
Total Sq. Ft of Construction: 1680
Sa1 of First Floor: 1580
n: $ Cost of Constructio1900.00
Utilities:Cn
�Ft.
Sewer E]
Septic
Building Height:
OWNER/LESSEE;
CONTRACTOR
.Name Fine Investment Properties Inc
Name: Roderick Waller
Address:10552 S US Highway 1
Company: Sunrise City CHDO
City: Port St Lucie, State: FL
Zip Code: 34952 Fax:
Phone No.
Address: 3550 Okeechobee Road
City: Fort Pierce State: FL
Zip Code: 34947 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.
r
SUPPLEMENTALCONSTR;UCTION LIEN
LAVINFORMATION'
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City: State:
Zip: Phone:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
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 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
_ Signature cf Owner/
STATE OF FLORID STATE OF FLORIDA
COUNTY OF Al" , COUNTY OF ^
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this TY day of 20 Eby thi� day of �" 20 &. by
(Name df person acknowledging) (Name of person
Racknowledging )
�,�
Si ature of Notary Public- Sta of Florida) (Sig re bf Notary Public- State of Ida )
Personally Known OR Produced Ident is io. Personally Known OR Produced Identification
Type of Identificatio tR511kHNtt'ruraAM �. Type of Identification Produced -
Commission No. ;�', `nc NotarY���o'6lto-State of Floiiita Py, Commission No. . s•(Seal)
MyCodpllcpiresDrc 2bte! f Zp 8
•� �� A� Commission X �" i9 Sapp "r'or,'••• 0 �„ JcG 20ZA9}
•nAiiuu•- Dun..-- _ f .. .uln H �a1 Notary Pss,•
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Revised 07/15/20 '--
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