HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TORE ACCEPTED
Date:
cl
Permit Number: ��� 1" 000
SCANNED
BY
St. Lucie Cou
Building Permit Application my
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 FOR: To Select from dropbox, click arrow at the end of line
ENT LOCATION:
Address:
M
Property Tax ID
Site Plan Name: A 26 L I
Project Name:
Setbacks Front Back:
Right Side:
Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF:WORKc 1
DrLjLwII removal and replacenunvi insulation remov0d + reply wv)
Gain+, replace in+2+rior oloor. (Drt�tocdl r- plo cenu-rat u.p -n a' 01X\Q�
floor riae -b -I'locdina -Prom Irmo-)
CONSTRUCTION INFORMATION
11HVAC Gas Tank Gas Piping
11 Electric Plumbing ❑Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 51 Cam. 00
Shutters ❑ Windows/Doors
Generator 11 Roof = Roof pitch
S�Ft.( of First Floor: _
Utilities: l� Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name-13iliormre
Cornmerri l 12e nliN Inve9tor5
Name: Michael J. Waldrop
Address: _1'aQ 1 Wicife nyent Ael I LUCCompany:
Innovation Contracting, Inc.
City: I=OY+ pifxce' State: FL-
Zip Code: 34g5O-4Fax: N fa
Phone No. 5Wk -114 ^,01,1,9(y
Address: P.O. Box 12757
City: Fort Pierce State: FL
Zip Code: 34979 Fax: N/A
Phone No.772-519-9108
E-Mail:+r((f`niproper-fiV AbPJJ4RQU tin, a
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW
INFO.RMATIQN`
3 .t',
E +,"
..
J. r
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name: *ei,�
Address:
Address:
City:
State:
City: rowele
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 County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or antl 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
improvemeriA to your property. A Notice of Commencement must be recorded and posted on the jobsite
before thefirst inspeytion. If you intend to obtain financing, consult Ith lender or an attorney before
commenafne work of recordine vour Notice of Commencement.
Si ature of 0 er/ Lessee/c6qActor as Agent for Owner
Si ature of r er/ icense Holder
TATE OF FLORIDA
STATE OF FL
COUNTY OF
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
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ZONING
SUPERVISOR
PLANS
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SEA TURTLE
MANGROVE
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REVIEW
REVIEW
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REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
-+,y x SEEM
urz� �'�-S�n;"«�"
MORTGAGE COMPANY: _
Name:
Y,
Not Applicable
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
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 County makes no representation that is granting a permit will authorize the permit holder to 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
improvemeoto your property. A Notice of Commencement must beffltorded and posted on the jobsite
before theffrst inspection. If you intend to obtain financing, consult th lender or an attorney before
as Agent for Owner
STATE OF FL
COUNTY OF
The or oinginstrum ntw accnowledg before me
thi day of 20by
c li
ame of person making statement 1
Personally Kno OR Produced Identification
Type of Identifi a iofi T__ /
(Signature of Notqy Public -State of Florida )
AarFl A M HUFFpeap
Notary Public - State of Florida
Commission 8 FF 234730
Rev.
REVIEW
_sX
STATE OF 1`6 A C� �.
COUNTY OF J I lc't
me
`Name of person making statement
Personally Kn con OR Produced Identification
Type a n i Produced rft /4
(Signature of Noory Public -State of Florida )
ANGELA M HUFF
Notary Public - State of Florida
MANGROVE
REVIEW