HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: 1 -1 ce - oan
Building Permit Application 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 -�`rtY, PL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential '
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I III
I PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: First Source Commerce Park Condominium (0
PropertyTaxlD#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
DETAILED DESCRIPT I ION OF WORK:
Ur�04Q fe=Vq� QoCk fP-PICLCe(Y\e(Xt i0SWQ-h0n MMOVC)Lk Wla
CePtCLC'e'MQ'nt) PW(W, I ntef to( GOU f-p-plactmUlt Cc)r�LxLlk
.I- -A "� N . ._� � n I � I �'.. '� I'll �r Al . rt L' 0 1 �� At^^ O�^�
CONSTRUCTION INFORMATION:
AaaitionaiworKtobenertormed under this permit— check all apply,.
HVAC 1:1 Gas Tank E]Gas Piping M Shutters Windows/Doors
Electric 1:1 Plumbing []Sprinklers Ilenerator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: S Ft of First Floor:
Cost of Construction: $ 6::) 000. (�O Utilities: Sewer E]Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name 9-7,7 KII2035 I-L-C
Name: Michael J. Waldrop
Address:_1010-1 Ht irl-y C'AuV-) LQnP
Company: Innovation Contracting, Inc.
City: PD1 IM Gpoch &(I y'de-()q State:EL
Zip Code: ;2j' Fax:
A!J JA
Phone No.
Address: P.O. Box 12757
City: Fort Pierce State: FL
Zip Code: 34979 Fax: N/A
Phone No. 772-519-9108
E-Mail:
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E-Mail: mwaldrc)p@innovationcontracting.com
State or County License: CGC1511910
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
PLO
�T Ji
DESIGNER/ENGI NEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
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 Coun makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in co 171ict with any applicable Home Owners Association rules, bylaws or an9covenants 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 r94 result in your paying twice for
improvementyto your property. A Notice of Commencement must /be corded and posted on the jobsite
lit
before the Vst inspection. If you intend to obtain financing, cons ilt ith lender or an attorney before
commenckTig work orxecording your Notice of Commencement.
ALrre of Ow r e Contr4or`as Agent for Owner
S iglo are of C ctor/License
STATE OW IDA
S LORIDA
COUNTY
COUNTY OF
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
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _NotApplicable
Name:
BONDING COMPANY:
Name:
—Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permittodotheworkand installation asinclicated.
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 permit holder to build the subject structure
which is in conwict 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
improvemeWto your property. A Notice of Commencement must beeorded and posted on the jobsite
tJ .
before theArst inspection. If you intend to obtain financing, consu Mt lenderoran attorney before
commencTing work of recording your Notice of Commencement. :7-, - 4
as
STATE OF FLORIDA <zf�-_/
COUNTY OF " TA Z, IL q.6-e_
me
day of
I riame of person making statement
Personally Kn — OR Produced Identification _Z
Type of Identi i a fito
Produced
(Signature of N + Pub7lic- State of Florida
AMGE1 A M HUFFtJCdi/
Notary Public - StatO ol Florida
commission # FF 234730
Rev. 8/2/17
REVIEW
S�ATE OF F6�A
COUNTY OF
me
'Name of person making statement
Personally KFnn OR Produced Identification
Type of Iden 1 !on -
Produced V�2_1 a
(Signature of No"ry Public- State of Florida
UV
ANGELA M HUFF —
Notary Public - State of Florida
MANGROVE
REVIEW