HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
SCANNED Permit Number:
BY
St. Lucie County RECEIVED
Building Permit Application SEP 2 i 2017
Planning and Development Services
Building and Code Regulation Division PERii; I:,,, -
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucle Cc Ur tf i-;
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION:
Address: ble)q South Kings Highway, Fort Pierce, FL 34945
Legal Description: First Source Commerce Park Condominium (OR 2522-1715) Unif A-112 PhI2Se -1
(OR AC514-c�(n;;)
PropertyTax[D#: Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTIONCIF WORK:,"'
Right Side: Left Side:
Block No.
Drqwct�� remoo+w1acemak, �osLAIQ_hm roovW+ repIcamt,
Palm- luefior doof rep00_eMeQt- (DrVwoffi replacement upio
ni r)lit�\jo P,\AnL- ri I I LD 4-r-, P_ I rAri Infi 0�r/NrA -V�vA^ N I
CONSTRUCTION INFORMATION: J
ACIortional worK to-Fe—r—)e—rfo`rm--eT under this permit — check all —apply:
11HVAC Gas Tank DGas Pip _ Shutters F-1 Windows/Doors
11 Electric Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq Ft of First Floor:
Cost of Construction: $ 6 rr>c). C�10 Utilities: n Sewer D Septic Building Height:
OWNER/LESSEIE:
CONTRACTOR:,
Name BiliMore CbrnmPyrial ReaN IniPst4s_LLkC,
Name: Michael J. Waldrop
Address: lla'l (1lra CIO q±.
Company: Innovation Contracting, Inc.
City: Ft)ir+ Pieyre State: _EL
ZipCode: "�41CILICI Fax:
Phone N a.. 0
Address: P.O. Box 12757
City: Fort Pierce State: FL
Zip Code: 34979 Fax: N/A
Phone No. 772-519-9108
E-Mail: IQ 0,1190 U-HI - R P_J
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: mwaldrop@innovationcontracting.com
State or County License: CGC1511910
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: N a"'
Address: Sawth 1; moo 1 1 @hW8y'-F6*P"erCV. ft-&$90- Addr.;s.:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Address:
City:
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 Coun makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
Mict with any applicable Home Owners Association rules, bylaws or an covenants that may restrict or prohibit such
which is in con, 1 9
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
improveme ts t four property. A Notice of Commencement must be recgrded and posted on the jobsite
before the If you intend to obtain financing, consult wit rider or an attorney before
commencing Workor recogliggVour Notice of Commencement. A
Sign7j of Owner/ L ctor as Agent for Owner
a
Signa e ct6r/License RbkLV'
3w, a
STATE OF FLORI
STATE Oi!:F;L50RI 'A
COUNTY OF
0
COUNTY 0
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this — day of 20 by
this _ day of 20_ by
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida
(Signature of Notary Public- State of Florida
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Mz' 041
DESIGNER/ENGI NEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip:
Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
—NotApplicable
BONDING COMPANY:
Name:
—Not Applicable
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 Court makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conlylict 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
improvemeggto your property. A Notice of Commencement must bept,orded and posted on the jobsite
before thq,#rrst inspection. If you intend to obtain financing, consult '" len der or an attorney before
commenffn2 work of recordinevour Notice of Commencement. r - I
as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The_torqoinginstrum tw ac nowledgW before me
this(_,J_L day of. 2 y
C,
garne`of pe'rsc�n making statement
Personally Kno' — OR Produced Identification
Type of Identifi a fo v-:z—
Produced
(Signature of N Public- State of Florida)
04Y - - - I
AmrFl A M HUFFtaeall
Notary Public - State 01 Florida
Commission # FF 234730
Rev. 8/2/17
REVIEW
STATE OF FIORWAS.__�—
COUNTYOF
me
'Name of person making statement
Personally Known OR Produced Identification
Type of iden ifi afnW
Produced
(Signature of Noory Public- State of Florida )
ANGELA M HUFF
Notary Public - State of Florida
MANGROVE
REVIEW