HomeMy WebLinkAboutBUILDING PERMIT APPLICATION°ALL AOPLIC(AABBII�INFO I,�� LISSTT BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `/, 'mot �I ( SCANNED Permit Number:
BY
St. Lucie County
Building Permit Application SEP z' 2017
Planning and Development5ervices Public' crl.s
Building and Code Regulation Division St. Lucie Counry.. F•_
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:,
Address: Rai 0- K i lrn,:� H I kwy Fnr-L_P_i Err_P Fl . ;:2� 4q 45
Legal Description: First Source CorfinercePark Condominium (OR, a5aa-1—►16) tinii RiCM
p)'ltaczle a (()12 aRl EN—a'l 1
Property Tax ID #: a3 it Ron-. CXian — con "- ?f Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Drywall removal and repWLcemei *, inq_ilation removal and
replacement, paint, interiordcor replacement. Wn-ILO tlk
r laugunt LAP to a' 0-100ue kor dlLe -b � lood i n -Prom Tcfra.)
CONSTRUCTION INFORMATION:
AClaitional work to oe nerformea un er this permit- check all app y:
�HVAC Gas Tank ❑Gas Piping _Shutters o ❑ Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: ScFt. of First Floor:
Cost of Construction: $ 5 C_)C) Utilities'. Sewer D Septic Building Height:
OW N ERAESSEE:
.CONTRACTOR.
NameCr1G C-niyirOnn-o—a ial SP_rVir'eS InC.
Name: Michael J. Waldrop
Address: 96A S. K Mc-, (%hWQN
Company: Innovation Contracting, Inc.
City: t'OYt pieXC.e Stater
Zip Code: ':SLAO45 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.
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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 antl 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 1 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_Wto your property. A Notice of Commencement must be orded and posted on the jobsite
before theyifrst inspection. If you intend to obtain financing, consult th lender or an attorney before
as Agent for Owner
STATE OF fLORIDA STATE OFF A r
COUNTY OF c L L Q.CA`�— COUNTY OF S-i—
The or oing instrum t w ac cnowledg before me
this day of 20J Ijby
c A4
ame 'of making statement
Personally Kno OR Produced Identification
Type of Identifi a i0
Produced
(Signature of Not
o Public -State of Florida)
NA rF! o M HUFFI_,)ear1
Notary Public - State of Florida
Commission S FF 234730
COMPLETED
Rev.8/2/17
REVIEW
The
me
'Name of person making statement
Personally Known OR Produced Identification
Type of Iden ifr a n � /
Produced
(Signature of No9ry Public- State of Florida )
ealj
NGELAM HUFF72rt2
y Public - State of Florida _
MANGROVE
REVIEW