HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ®� O�
Date:
SCANNED PermitNumbera %�:
a u
BY
St. Luce County SEP 2 1 2017
•
Building Permit Application Public l4 <r
Planning and Development Services St. Lucie Co",
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
Add ress:
Legal Description: First Source Commerce Park Condominium (09 aciaa — 1�1 �rj ���n 1_V F3 i OL P
Phase a (OR 25G Lv - 3301
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
.DETAILED DESCRIPTION OF WORK: III
Drywall removctl and re placeme�n+, i► sulck-ho • fmoval and
reQlacemefnar, point, Mtenor door (eplacenuA-t- (Drywall
r a me.nt u b a' 0_Pove �A00r due to �lood(n Fran Irma)
CONSTRUCTION 'I N FORMATiON;
0HVAC
Gas Tank
Gas Piping
UShutters
❑
Windows/Doors
0 Electric
0
Plumbing
Sprinklers
1:1 Generator
1:1
Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 6 000. OCR
S Ft. of First Floor: _
Utilities: Sewer[] Septic
Building Height:
OWNER/LESSEE:-
CONTRACTOR:
Name Thcw-nQS IF W-e0,fiY\6 a
Name: Michael J. Waldrop
Address: 55 Ri Ve ( OYI VP
Company: Innovation Contracting, Inc.
City: nxuAesga State: _EL-
Zip Code: �34Loq Fax:
Phone No.
Address: P.O. Box 12757
Fort Pierce FL
City: State:_
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
MORTGAGE COMPANY:
Not Applicable
Name:
_
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _
Not Applicable
BONDING COMPANY: _Not
Applicable
Name:
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 priorto the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holderto 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
improveme to your property. A Notice of Commencement must be orded and posted on the jobsite
before theArst inspection. If you intend to obtain financing, consultyffth lender or an attorney before
as Agent
STATE OF FL
COUNTY OF
The or oing instrum nt w ac nowledgqtbefore me
thi day of 20J Ijby
c
ame 'of making statement
Personally Kno OR Produced Identification
Type of Identif1 a i0
Produced I — — ' A
(Signature of NIP Public -State of Florida )
NSF! o M HUFFheaq
Notary Public - State of Florida
commission N FF 234730
DATE
Rev.
REVIEW
Sierfature o r License Holder
STATE OFF A j
COUNTY OF
me
'Name of person making statement �^
Personally Known OR Produced Identification ok
Type of Iden i t aj n J
Produced Y �/ 14
(Signature of No'ry Public -State of Florida )
ANGELA M HUFF
Notary Public - State of Flonda
MANGROVE
REVIEW