HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 7 n
Date: SCANNED Permit Number: / /O%'M9.3
BY
St. Lucie county REE ®
Building Permit Application SEP 2 1 2017
Planning and Development Services
Building and Cade Regulation Division PERMhrlNGSt. Lucie
2300 Virginia Avenue, Fort Pierce FL 34982_ county, Ft -
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Y Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: Rzo Pnuih Kogs HiQhLuQv Fort pierc-eI FL 34QL46
Legal Description: 1=1( SoUrc� COmmeirce �] ry, Condnry) am
FOR 615616!- I1 1 ) � Q4 12,I6P, Pha5 1 (OR 3, 991- 6114-5)
Property Tax ID #:3A — CC O-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
c)rquim removed c-replacedt insulation retnove 4o2pio ceo, plwot,
in+aior Boar replacement. WfL�t nt 1 r2pl4cemea+- up -lo a' 0-00ve
door due -b �Iwdinq -From Irma)
CONSTRUCTION INFORMATION:
Additional work to a erorme under this permit —ca apply:
OHVAC 0GasTank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric El Plumbing Sprinklers I Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: Sq Ft. of First Floor:
Cost of Construction: $ 000.co utilities., Sewer 0 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name glltt)nmre Cnm11 RWRV InU2-tbr8 (
Name: Michael J. Waldrop
Address: Iaal IQW re AVEniiY.
Company: Innovation Contracting, Inc.
City: f7hr-4 (?ierce. State: _F_1_
Zip Code: 3 8g5Q— Li0$1tax: N) A
Phone No. �(D I — 11 q— ��ciLa _
Address: P.O, Box 12757
City: Fort Pierce State: FL
Zip Code: 34979 Fax: N/A
Phone No.772-519-9108
E-Mail:froi:IWW1_1(OTXfiV�1�e11S6L ne+
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.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: fttp elm State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: rmy-
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
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 thepermitholder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an 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, 1 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 TOO ER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvementsr your property. A Notice of Commencement must be recorded and posted on the jobsite
before the fir inspection If you intend to obtain financing, consult wit ender or an attorney before
commencin work or reoWdLRF vour Notice of Commencement.
Sigrrature essee/Contrac gent for Owner
Signatu Holder
S ATE OF FLORIDA
TE OF FLORIDA
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
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
j, 'Ka #3hY.�t}+ +. s�y['p
C �1�1
5�,��ii Rpm
�:
k [ i
u��i 1` � � C4`a. , -ice -s^ ..��N,
MORTGAGE COMPANY: _ Not Applicable
DESIGNER/ENGINEER: — Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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 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 1 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
improveme to your property. A Notice of Commencement must be orded and posted on the jobsite
before th rst inspection. If you intend to obtain financing, consult th lender or an attorney before
comme ne work of recording vour Notice of Commencement.
as Agent for Owner
STATE OF FL
COUNTY OF
The or oinginstrum ntw accnowledg before me
thi dayof 20(by (
c li
ame of person making statement 1
Personally Knovty�((�� OR Produced Identification
Type of Identift¢atio/i T— /
(Signature of Notly Public- State of Florida )
aur.Fi a M HUFFFWeaq
Notary Public - State of Florida
Commission N FF 234730
Rev. 8/2/17
REVIEW
Sierfature o r License Holder
STATE OFF A C�� u—Gr
COUNTY OF J s
me
'Name of person making statement
Personally Kn wn OR Produced Identification
Type of Iden ifi f /
Produced / ti—/
(Signature of Noory Public- State of Florida )
ANGELA M HUFF
Notary Public - State of Florida
MANGROVE
REVIEW