HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C.Nal Permit Number:
RECEI!'rD 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 Com Q, a vdv II
PROPOSED IMPROVEMENT LOCATION:
Address: B5ci onuth Kj2gq H )j, Fbt-- Piexcp, iFt- Sz4gL gs
Legal Description: First Source Commerce Park Condominium
Pha�P � �13Q ?�15f�-loa9�
PropertyTaxlD#: Lot No.
Site Plan Name: \A\i'3�a001-oaBlock No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
OrywcM removal and replacement-, iosWcktion rernovol and Ceplacenun}I
paim-, it\kerior door rt?placemsnfi. cDrywall repktcen\_e " tA.p io a,oabove
door clue -ta .Ftoodin9 -From Jana.)
CONSTRUCTION INFORMATION:
AacitionaiworKtot3enertormed under tis permit —c ece all apply:
OHVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator D Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ C;.BC� •oC)
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
OWNER/LESSEE: "
CONTRACTOR:
Name "&0+hEr-Vno[ EPrtiP_S Inr�.
Name: Michael J. Waldrop
Address: Q1.-10 PjaPrvI IIQQP C0(Jrt
Company: Innovation Contracting, Inc.
City: "1bI Re-^t7 h jAr pans State: -EL.
Zip Code: ?�i�l 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.
DESIGNER/ENGINEER: _
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _
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
improvemeW to your property. A Notice of Commencement must be orded and posted on the jobsite
before theyffrst inspection. If you intend to obtain financing, consult h lender or an attorney before
comme ng work of recording your Notice of Commencement. -
nature o net/ Lesse ntrector as Agent for Owner
Si ature o r License Holder
STATE OF FLORIDA <zZ % `
COUNTY OF T, L Q•�L—
STATE OF F A J +
COUNTY OF �� GPI SLGb�
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The or oing instrum
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The forgoing instru 2At was ac nowiedggq be re me
this day of
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this clay of 204,JP
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ame of person making statement
ame of person making statement
Personally Kno
OR Produced Identification
Personally Kn wn OR Produced Ident�catfon
Type of Identifi a i
Type of iden t t a ion
Produced
,
Produced
(Signature of No
Public- State of Florida)
(Signature of N ryPublic- State of Florida )
Comm! ton•, o.,,
ANGEa n M HUFF(Seal)
Com eal)
2o�N,. Pe;`•.
Notary Public - State of Florida
-',ioiw�>Za�,, ANGELA M HUFF
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Commission # FF 234730
3 ;°= Notary Public - State of Flonda
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iREVIEW�
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17