HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: O `
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
Address:iLB. KjnqBighunW.it !
Legal Description: First Source Commerce Park Condominium (-)Ai+ A -loci
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
Left Side:
Block No.
Dry Na removgl Qna rep lace mete, i nsula-H on remov0.l and
repl tcemmv, mink, v\ia(ar door replocerv-Q-At CDrlwQll
r QCP.M M LAp -to 2' 0,bove ( ctue -b � 16W'inq from Irma)
CONST,RUCTION;INFORMATION:,' t
z �x
Ada
ttiona wor to e e orme under tispermit-check a apply:
11HVAC Gas Tank Gas Piping _ Shutters Windows/Doors
Electric El Plumbing Sprinklers 11 Generator E]Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ COO
S Ft. of First Floor:
Utilities:InSewer 0Septic
Building Height:
:;OWNERJLESSEE:?9
CONTRACTOR = ^ � ,� a : ,
NameC2G EnVircr)m a f i 0-k SpryireS JnC
Name: Michael J. Waldrop
Address: B6,9 5. Kjoqq HI A,)N
Company: Innovation Contracting, Inc.
City: FOri' pi2rCe State: F,
Zip Code: ?�4QN5 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: _
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
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
improvemeryJaito your property. A Notice of Commencement must be orded and posted on the jobsite
before the
rst inspection. If you intend to obtain financing, consult th lender or an attorney before
STATE OF FL
COUNTY OF
The or oing instrum nt w ac cnowledgqo before me
this day of 20(by
c
ame of person making statement
Personally Knovip OR Produced Identification
Type of Identifi a i'
Produced
(Signature of NotPublic-State of Florida )
mdr,Fl 4 M HUFFPeaq
Notary Public - State of Florida
Commission # FF 234730
REVIEW
Rev.8/2/17
�e0� F2A U12
STATE OFF A I
COUNTY OF ) �IStC[
me
'Name of person making statement
Personally Kn wn OR Produced Identification
Type of ]den fi ajion /
Produced / f—/ i 1
(Signature of Noory Public- State of Florida )
ANGELA M HUFF
Notary Public - State of Florida
MANGROVE
REVIEW