HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/1L2017 6GANNED Permit Number:
--- 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) 462-1578
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEMENT LOCATION:
Address: 1107 S. 33RD ST. Fort Pierce, FL 34947
Commercial xxx Residential
FEB - 2 2M1S
Puu11_ Works
St. Lucie County, FL
Legal Description: 17 35 40 E 200 FT OF S 1/2 OF S 112 OF SE 114 OF NE 1/4 OF NW 114-LESS S 70 FT AND LESS ST- (31)(0.37 AC) (OR 3710-1745)
Property Tax ID If: 2417-214-0007-000-2
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALL A UESED 12 DOOR REACH IN / WALK IN COOLER.
CONSTRUCTION INFORMATION:
LJHVAC
"Gas
Tank
11 Electric
0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction:
$ 6812.00
JCI II IIL-L11UL.RGII d"'Y:
Gas Piping _Shutters
Sprinklers 1:1 Generator
S Ft. of First Floor: _
Utilities:n Sewer []Septic
Lot No.
Block No.
❑Windows/Doors
0 Roof = Roof pitch
Building Height:
OWNER/LESSEE:
'CONTRACTOR:
Name CYRIL THOMAS
Name: JAMES T SMITH
Address:8125 WESTFIELD CIR
Company: REASMI INC
City: VERO BEACH State: FL
Zip Code: 32966 Fax:
Phone No.772-646-2215
Address: 320043RD AVE SUITE 6
City: VERO BEACH State- FL
Zip Code: 32960 Fax: 772-770-0508
Phone No. 772-770-0507
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: JIM.SMITH@COMFORTZONEACNOW.COM
State or CounYyLLi'c_ein5e: CAC057477
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUFPLEMENTAL:CONS_TRUCTION.�LIEN LAW INFORMATION:", - ".--.=_ : "_ ""� - ` � "-
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
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 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.
�1
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDAS_�_' ^ , e—
COUNTY OF �K_4
The fefgoIng instr{ enQy�as acknowledgq efore me
this o_d�dayof_j�' 2 1 201-iby
a�a .Sm
(Name of person acknowledging )
of lAbtary Public- State of
Personally Known OR
Type of Identification Prgdusg
AHGELA M HUFF
tary p.,hart - State of (Sep
Commission # FF 234730
National
s
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF rJ�!
The forgoing instrument Mfaas acknowledgeo before me
this.-Xday of 1FJ 201 V by
(Name of person acknowledging )
Signature of Notary Pu i -State of Florida )
Personally Known OR PrroodAred Identjfi4ayon
Type of Identification Produced (f� }--�
ANGELA M HUFF
r -t—aryPuffc Mate of Flom
Commission # FF 234730
Bonded
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
r ... -
ALL APPLICABLE INFO MUST BE COMPLET) u POR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: � % (7� ,01�
BY
~- 3t Lucie County
`Building Permit Ppl'
Planning and DevelopmentServires
Building and Code Reguiadon Division
2300 Virginia Avenue, Fort pierce FL 349R2
Phone: (772) 462-1553 Fax: (72)4§2-1579 Commercial
9NNOTIii
Legal Description:
FOR: To Select from dropbox,
Property Tax ID#:ALI(`1- 3LI4-�7'om a -
Site Plan Name:
.5 I
Residential
arrow at the end of line
RIGas Tank £
Gas Piping - -Shutters• : Sprinklers Generator
Total Sq. Ft of Construction: S Ft f Fi
r.
• CO ■ Sewer■. Septic
Zip Code:
Phone No. '1`1
Eq
Fm m fee imple-Title Holder on next page (if different
from the Owner listed above)
Is $25W or more, a
Name: z
Company:
Lot No.
Block No.
❑ Windows/Doors
Roof Roof pitch
Building Height:
:L �.l•�.I 6'.�11 11 1 I
State or ounty License:
�, I • , ,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: —Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is g
which isin conflict with any applicable Home Owr
structure. Please consult with your Home Owners
the
may
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
STAE OF FL
COUTNTYOFORIq �
The forgoing instrument was acknowledged before me
this
�_day of 20 by
y�9f�uel' T �u`dra�x
(Name of person acknowledging)
PersonailyKnown
Type of Identificatiorrl
.•6
i
Commission No.
Revised 07/15/2014
STATE OF FLORI //
COUNTY OF Oe1/71 t C[GfC'�
The forgoing instrument was acknowledged before me
this
�day of 200by
(Name of person acknowledging)
of
Personally Known v
'Type of Identification
Commission No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED