HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
r5, ,.--+ SCANNED
BY
-Imitding 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
RECEIVE-
SEP 2 1 2gl.-
Public War
St. Lucie C,,�
Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line II
PROPOSED IMPROVEMENT LOCATION:
Address: 8tflal S . K-i n qo, H Li En r+ Pi Px-ce F1=A !i9 ei5
Legal Description: First Source Commerce Park Condominium 012 bM,90 —1-115 i U 01+ A-10a
PhaclP "i (AQ aAG-1- I0RA) _ , — _C
Property Tax ID #:��{i --JG
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Block No.
DETAILED DESCRIPTION`OF WORK:
Or
wall replacemwt OnC( re(noVWl 08ulQti'an removal arnd
oaceimt, paint, interio(aclor replacau(it CDr�u_)Wk
✓n nlnno M n na, g*, " _L� �r rxlnn, 16 rif 1.0 _1^ Clnni-I;nn jn'rArn T rr An
I CONSTRUCTION INFORMATION; J ,
HVAC LJGas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ !Fp—�00(). 00
Piping UShutters ❑Windows/Doors
nklers U Generator U Roof = Roof pitch
ScFt. of First Floor:
Utilities: Sewer 0Septic Building Height:
OWNER/LESSEE: q
CONTRACTOR;
Name A
Name: Michael J. Waldrop
Address: a;960 Chr rate Dr\
P.
Company: Innovation Contracting, Inc.
City: 5QV n+n0 R PoCh State: a
Zip Code: �;34a tip -_ 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.
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ 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 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
improvemeW 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
commenknework of recording vour Notice of Commencement. _ ,
as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The for oing instrum nt w ac cnowledg before me
this day of 20 by
c `1
ame of person making statement
Personally Kno OR Produced Identification
Type of Identi i a i;
Produced L— '
(Signature of Notgy Public- State of Florida )
u/ NGS n M HUFKI earl
Notary Public - State of Florida
commission 8 FF 234730
Rev.8/2/17
REVIEW
STATE OFF A )
COUNTYOF
me
'Name of person making statement ,/
Personally Known OR Produced Identification
Type of ]den i i ajiOn
Produced / f / d
(Signature of Noory Public- State of Florida )
ANGELA M HUFF
Notary Public - State of Florida
MANGROVE
REVIEW