HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
PermitNumber: 1'�-vpq-oazy
Date:
SCANNED
Building Permit Application BY
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Y Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
PROPOSED IMPROVEMENT LOCATION: -, , � �:. _ I �� .� -1 1 111
Address:
Legal De!
(OR Qc5aa 1-115 - Una Filos 2Mqe *a (QR3tp0i-a10-3
PropertyTax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
DETAILED,DESCRIPTION OF WORK:
Drywd rellwiva'i and replolcenent, insuloAio(� removat and
f-epliaceme,M-, pa�m-, in-vi?-rior dcoc f-epliaumenk. CjDr�wall
reg=mw UQ tb a, above A= due -b ��COCUOQ I(= Tri-no-)
CONSTRUCTION INFORMATION:'
Additional work to be nertormed under this permit — check all apply:
E1HVAC [1GasTank []Gas Pip _ Shutters []Windows/Doors
11 Electric El Plumbing E]Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft of First Floor:
Cost of Construction: $ Utilities: Sewer OSeptic Building Height:
OWNER/�ESSEE: -
CONTRACTOR:
Name 2ae-r
Name: Michael J. Waldrop
Address: rllc;C)6�3 lic. N
company: innovation Contracting, Inc.
city: F-Gn- Pieycle V State:
ZipCode: ?_'�L4QR1 Fax:
Phone No.
Address: P-0, Box 12757
City: Fort Pierce State: FL
Zip Code: 34979 Fax: NIA
Phone No. 772-519-9108
E-Mail:
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.
I .�'_ I � _� I a� I ��' I �" '�' , � � , 1, � ._11 1.11 1 11 , 'Fe, - _� llr '
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DESIGN ER/ENGI NEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
city: P.11
Zip: Phone:
—State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
—Not Applicable
Add ress:_PQasa76;,
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 permit holder to build the subject structure
which is in con%ict 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 OWD)ER: Your failure to Record a Notice of Commencement ma suit in your paying twice for
t su
improvements Wour property. A Notice of Commencement mus- e re ded and posted on the jobsite
i r
before the fir nspectioryAyou intend to obtain financing, consu vi ender or an attorney before
commencinwolrk or reobrdVng your Notice of Commencement.
Si ture of 0 Agent for Owner
on rac o
ZATEOFfO.
Signat ense Holder
IDA
STATE OF FLOROIDA
'T
COUNTY
COUNTYOF
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
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
N - M
DESIGN ER/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: —Not
Name:
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 permit holder to build the subject structure
which is in conMict 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
improvemeg$ to your property. A Notice of Commencement must beWtorded and posted on the jobsite
before th " st inspection. If you intend to obtain financing, consult th lender or an attorney before
rommen2na'tork of recordiniz vour Notice of Commencem6nt. YPO - 4
M
STATE OF Fl.
COUNTY OF
day of
�1/
as Agent for Owner
STATE OF FiORWAS_�-
-(?-- I COUNTY OF -
before me I The
Name of person making statement
Personally Known OR Produced Identification
Type of Identi
Produced ��*if— �7L— 14
(Signature of Notqy Public- State of Florida
amari A M HUFROudil
Notary Public - State of Florida
commission # FF 234730
I COMPLET
Rev. 8/2/17
REVIEW
me
'Name of person making statement
Personally Kngwn —.--OR Produced Identification
Type of Iden ifi a ion
Produced PY 14
(Signature of No"ry Public- State of Florida
UV
ANGELA M HUFF —
Notary public - State of Florida
MANGROVE
REVIEW