HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APELICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: cT-,�i-1-7 Permit Number: r1
ocl - 63 I 3
SCANNED
Building Permit Application By
Planning and Development Services Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 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 Ill
hill
Address: R"'I l KingS lluu . rt pierC.C. R _ ?�z4q S
Legal Description: First Source Commerce Park Condominium t )ni+ A-10-1
RVICISP -1 cop, ?215- (-) - 1414)
PropertyTax lD #: 0�311 —Tscc� t r titer i� c n yq366d ((2ii 1 Lot No.
Site Plan Name:
Project Name:
Setbacks Fri
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Block No.
orywcall removal amd replacement, insulation removal and
replacement-, paint, interior doov replacems-Rt C47r\q"Wk up to L
CONSTRUCTION INFORMATION: ill
UHVAC
UElectric
J Gas Tank
U Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ rb[J0 . 0`23
Gas Piping U Shutters ❑ Windows/Doors
Sprinklers U Generator 1:1 Roof = Roof pitch
S Ft. of First Floor:
Utilities: nSewer 0Septic Building Height:
.OWNER/LESSEE;
CONTRACTOR: ,
Name S-19 KIMSi.'
Name: Michael J. Waldrop
Address: 1 OIC1-1 un+ t" t lh F I_nne
Company: Innovation Contracting, Inc.
city: PQI M PAECI Ch CICLr C[05S State: _f
Zip Code: 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.
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City:
Zip: Phone:
State:
BONDING COMPANY:
Name:
_Not Applicable
Address:
City:
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 con lict 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 the rst inspection. If you intend to obtain financing, consult th lender or an attorney before
comme ne work of recordine vour Notice of Commencement.
as Agent for Owner
STATE OF FL
COUNTY OF
The or oing instrum t w ac cnowledg before me
this day of�20by (
l
ame of person making statement
Personally Kno OR Produced Identification
Type of Identifi a io/t
Produced L
(Signature of NotPublic-State of Florida )
Commi ton• o„ erJrvf e M HUFF(Seal)
4P0.Y P48�•i
Notary Public - State of Florida
'.' �i : •'_ commission # FF 234730
REVIEW
COMPLETED
Rev.8/2/17
M
Signature o r License Holder
STATE OF F A
COUNTY OF i-
The fot'eoine instrument was acknowledeed-before me
'Name of person making statement
Personally Kn wn OR Produced Identification
Type of Iden ift 7ion
Produced r
(Signature of Noory Public- State of Florida )
ANGELA M HUFF
Notary Public - State of Florida
MANGROVE
REVIEW