HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1LL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED "" �
Date: SEP E 1 VjFmit Number: I Cy / �l
Public works
St. Lucie County, FL
Building Permit Application SCANBY
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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line II
PROPOSED IMPROVEMENT LOCATION:
• • ,
Legal D•scription: First Source Commerce Park Condominium� •
ho- 02- it
•,.
Site Pla 1 L.0
Project Name:
Setbacks Front Back: Right Side: Left Side:
Lot No. v'
Block No.
l�DETAILED,DESCRIPTION'OF.WORK: ° .
Dry(unil removal 00d r-eplaceMMtl WSWG(bon removal ana
replacMent, paint, interior door repio_cemenfi. Dr\�/I}'wall `
_/� In r�M^Al_ Ia! -k— no �tniw." 01 w...i rl,.n t_ 111-.-4; n 1+_rn Nl �✓•M /l 1
CONSTRUCTION INFORMATION:
Additionalwor to e e orme un ert Ispermit-c ec a appy:
0HVAC F] Gas Tank ❑Gas Piping _ Shutters l] Windows/Doors
0 Electric 0 Plumbing Sprinklers 1:1 Generator Roof = Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
�.� Cost of Construction: $ Q. 00 Utilities:Sewer Septic Building Height:
OWNER/LESSEE:
T
Name -5
me: ichael . Waldrop
Address:
pa ntracting, Inc.
'
_City_ Ep4otpfKSt a e: L
Zip Code: Fax:
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 ( 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.
'(f'> `F# t..P`ee
MA t ► r � �
R 1` 5 � M �� P
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
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 County makes no representation that is granting a permit will authorize the permit holderto 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
improvemto your property.A Notice of Commencement must be orded and posted on the jobsite
before th ist inspection. If you intend to obtain financing, consult th lender or an attorney before
commen ne work of recordine vour Notice of Commencement. _ ,
as Agent for Owner
STATE OF FL
COUNTY OF
The or oinginstrum ntw ac<nowledg before me
this day of 20 by
CA
1
ame of person making statement
Personally Known OR Produced Identification
Type of Identifi a iof
Produced �
(Signature of No qy
Public -State of Florida )
nurn A M HUFFt.,)eaN
Notary Public - State of Florida
commission # FF 234730
RECEIVED
Rev.
REVIEW
STATE OF F6RiDA +
COUNTY OF S--�- LiGb
tRN
Name of person making statement �-
Personally Kn wn OR Produced Identification
Type of Iden ifi ag n
Produced _
/ 19
(Signature of Noory Public -State of Florida )
ANGELA M HUFF
Notary Public - State of Flonda
MANGROVE
REVIEW