HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED PermitNumor; JIM-WrOp
BY ItUE11VED
I ucie County
SEP 2 ; 2017
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 Commercial X Residential
PERMIT APPLICATION F OR: To Select from dropbox, click arrow at the end of line
PROPOSED- IMPROVEMENT LQCATION:-
Address: R?sc� R. Kina-q "inht,00ij Pi9_VC_e_ Pl- A�Q(4c:73
Legal Description: First Source Commerce Park Condominium (OR acs a C3 - Hnit A -I ko
I?IIQSF' I (OR, ��114-61o0a)
PropertyTaxlD#: QA11—B(Y)—C)C)IC)—C)CC_C) Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
bETAILED NESCR'IPTION OF,WOW
DrYwW removal Ono replace-MoMt, iasulaficlR removW GLACA
f-.eplQc,e,meR�, poLiRt, interioc door rep(aceffopAt Oaju_)QU
L , � I— ell )A Linn /-4, 1) 1, VJA^eA ir%n 0,��
CONSTRUCTION, -INFORMATION:
11HVAC Li Gas Tank
11 Electric El Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
Piping 0 S'hut'ters []Windows/Doors
nklers []Generator 0 Roof
Sq- Ft. of First Floor:
Utilitles:E] Sewer 0 Septic Building Height:
Roof pitch
QWNER/LESSEE:
'CONTRACTOR':':
Namel5EIG—mre Cornme.ri-fok Reolttj
InveWcOg I LLC
Name: Michael J. Waldrop
Address: IIQ'1 C1 nd(a
company: innovation Contracting, Inc.
City: 9ie)rcf-
Zip Code: �J 14 C1 L4 9 Fax:
Phone No,
State: fL,
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: mwaldrop@innovationr-ontracting.com
State or County License: CGC1511910
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
00 �Y`iku�
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R
DESIGN ER/ENGI NEER:
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:
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 Mict with any applicable Home Owners Association rules, bylaws or a ng covenants that ma estrict or prohibit such
N Ic
structure. Please consult with your Home Owners Association and review your deed for any restrictions w h 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 rj;ay result in your paying twice for
)e.
improvements,W your property. A Notice of Commencement must be corded and posted on the jobsite
before the fil inspectioyn If you intend to obtain financing, consul
h lender or an attorney before
commencil;rWork or re r"g your Notice of Commencement. ��J 11
Z'4.19 , C"j-
Stg tdre of Ownek"le or as Agent for Owner
SifyKat 0 r/License Holcl�r
STATE OF: FLORIDA,, r
STATE OII�F�L#DA C��
COUNTY OF SAn (_J"c_A-e_-
COUNTY
The forgoing instrument w k I d 9before me
this by
T e r oing inst:rui�n:t;�wasMknowledg�"efore me
th is day f 20/ by
M
Cry)
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification I'/
Type of Identificati
Produced— T—,/,
Type of Identifica
Produced
-n,-f--
(Signature of UFF
Commission Notary ublic - of Florida
ission 34730
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17