HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: °��� 1 11 Permit Number: 11 OA' da,� s
` ' " - RECEIVED SEP 212017
___-- 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 �_ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line C . .m . lk%Y -Jac .I
Address: R1D5 S'. KingG Nloq., �lly,+ Pierce, FL .n_,4A"S
Legal Description: First Source Commerce Park Condominium 60kRS0—?a-1`1 IGii Un i+ 5I�
PhGkSe 42 (1L3g-6g- 1910
Property Tax ID #: o — Lot No.
Site Plan Name: 3, aea 000 - O� Block No.
Project Name:
Setbacks Front Back:
Right Side: Left Side:
DETAILED,DESCRIPTION'OFWORK
I)rywall removal and replacement Insulation rpmaval and replacem .,
pVIM-ri Avefiof door repla.cem u'It - CDryl,zl l r2plo cem-cod- u-P -b a'
a
v '7.
CONSTRUCTION INFORMATION:
AaamonalworKtooe ertormea
11HVAC Gas Tank
unaerinispermit-cneCKan
Gas Piping
apply:
Shutters
Q Windows/Doors
_
11 Electric
0 Plumbing
❑Sprinklers
11 Generator
E]Roof Roof pitch
Total Sq. Ft of Construction:
Sq.
Ft. of First Floor:
Cost of Construction:
$ 161 C)00. 00 utilities:
Sewer Septic
, Building Height:
OWNER/LESSEE: . ' �
;CONTRACTOR:: _.
Name nI2 U _C
Name: Michael J. Waldrop
Address: 1o103 60\J 2d . Ant. 61000
Company- Innovation Contracting, Inc.
City: Ut? ro E� e(ar� 1 State: _fFL-
Zip Code: 3clgto3--i3ly Fax:
Phone No.
Address: P.O. 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.
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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 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
improveme to your property. A Notice of Commencement must be orded and posted on the jobsite
before theArst inspection. If you intend to obtain financing, consult th lender or an attorney before
as Agent
STATE OF FL
COUNTY OF
day of
c
me
Name of person making statement `
Personally Knowri OR Produced Identification
Type of Identifi a iofr
Produced
(Signature of Noqy Public- State of Florida )
pb nFl A M HUFFNeml
Notary Public - State of Florida
Commission p FF 234730
REVI
Rev.8/2/17
REVIEW
STATE OF FC9RfIIA COUNTY OF )' GL
me
Name of person making statement �^
Personally Kn wn OR Produced Identification (-
Type of Iden l ajion J
Produced
(Signature of No"ry Public- State of Florida )
ANGELA M HUFF
Notary Public - State of Florida
MANGROVE
REVIEW