HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONo
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �J
Date: ! —a j— 17 Permit Number:
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 X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION: '
Address:
Legal Des
(DR atiaa-11 15) Unit C_Ida Phlace I (OR ,�31c0 rb - ►k_o84)
Property Tax ID #: a I — R00 — Mapes — 0100 —Q Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
J.DETAILED DESCRIPTION OF WORK.
Drywall removal, insulation removal, inSUlaiion replcacementj
drywall replacement-, pain-v, interior door rep-bv_ement. (D(-pa
repol,cernent up to 2.' Feet QboVe �=r due -to RIWOing -Rom Ifmoa )
CONSTRUCTION INFORMATION:
LIHVAC U Gas Tank Gas Piping
Electric 1:1 Plumbing []Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ �_O .00
Shutters ❑ Windows/Doors
Generator 11 Roof = Roof pitch
S Ft. of First Floor: _
Utilities: Sewer D Septic
Building Height:
'OWNER/LESSEE:
=
CONTRACTOR:=
- -
Name bikiDMOr2 Commercial )mmerccia�,lIaril If1VP.41z�f
Name: Michael J. Waldrop
Address: 1 %&'1 YQfY'JQ 3!i Q�-t I L
Company: Innovation Contracting, Inc.
City: EbTt PIeYCe, ` State: 5,
Zip Code: 34a4G Fax: N 1 A
Phone No. 5(01--IIC1-5JrS(p
Address: P.O, Box 12757
City: Fort Pierce State: FL
Zip Code: 34979 Fax: N/A
Phone No. 772-519-9108
E-mail: triCjP. pfop aU @be11SaAUAb. net
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 $2S00 or more, a RECORDED Notice of Commencement Is required.
SUP PLEMENTAL'zCONSTEtUCTiON LIEN LAW INFORMATION
DESIGNER/ENGINEER:
Name:
_ Not Applicade
MORTGAGE COMPANY:
Name: yea
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City: r•e+ple—
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:>z
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
improvements tp your property. A Notice of Commencement mus be recorded and posted on the jobsite
before the fir Inspection. If you intend to obtain financing, con It with lender or an attorney before
comment work or re rdin our Notice of Commencemen .
ature o wne essee/Contractor as gent for Owner
gnature offont�etor/License Holder
ZATE OF FLORIDA Jl
STATE OF FLORIDA
COUNTY OF C��G�
ve
COUNTY OF "JiirL I've
The f r ng ins ment wa ac wled efore me
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The for oing instru nt was cknowledg efore me
this ay of 20 by
this�ay of 20' y
erson making statement
erson making statement
Pe sonall OR Produced Identification
Personally Known OR Produced Identification
e of Identification
Type een
Produced
DZ
Produced
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Commission' '+ ommisston # FF 2 R 15
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National Notary Assn.r
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REVIEWS
FRONT—
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
12-claa l A Ut7—