HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONti
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ,\ F�ni N. N1— Permit Number:
RECEIVED SEP 211017
____=- -- -- 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(_am �ig{�dQq c
PROPOSED IMPROVEMENT LOCATION:.,
Address:
Legal Description: First Source Commerce Park Condominium C09— a.S a o7— 1-1 15 i Unit R M
Phase a (02 3ic5a- na1)
Property Tax ID #: -t306?4 - CX:�O - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
I' DETAILED DESCRIPTION OF WORK.
Dryu. l removal and rep lace nunt, i0SUlct- ion removal and
replacemexi-, paink, i A-erioc poor replecerwL.nfi. CDryL.0Qll
Lepliaceme,nt LA12 to 2' ctloove Moor due to ftoci i (IQ 4oliyt
CONSTRUCTION INFORMATION:
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IJHVAC U—GasTank E]GasPiping
11 Electric 0 Plumbing Sprinklers
Shutters ❑ Windows/Doors
Generator Roof = Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ C1I�C�.�C) Utilities: Sewer Septic Building Height:
- OW N ERAESSEE:
CONTRACTOR: t .
Name WPQ-FheV1-n.�4 erne "es Iflc.
Name: Michael J. Waldrop
Address: aQ'10 1&a4 V i ilagf- C'OU'a
Company: Innovation Contracting, Inc.
City: PQ1M ae.QCn1 icur eln(; State: fL
Zip Code: � 3 3 10 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: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants 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
improvemeggto your property. A Notice of Commencement must beotorclecl and posted on the jobsite
before th rst inspection. If you intend to obtain financing, consult th lender or an attorney before
commen , ne work o1 recordine vour Notice of Commencement. _
as Agent for Owner
STATE OF FL
COUNTY OF
The or oing instrum nt w ac cnowledg before me
thistni, I day of 20 by
i
ame of person making statement 16
Personally KnT OR Produced Identification
Type of Identi10J
Produced
(Signature of NotPublic-State of Florida )
un rn A M HUFFWear)
Notary Public - State of Florida
commission # FF 234730
Rev.8/2/17
JPERVISOR
REVIEW
STATE OF F ) I
COUNTY OF
or
me
'Name of person making statement �^
Personally Kn wn OR Produced Identification
Type of Iden i i jion J
Produced / f—/ IX
(Signature of Noflry Public- State of Florida )
nneeLA M HUFF
Notary Public - State of Florida
MANGROVE
REVIEW