HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Numb ��ppc
BY
i " = St Lucie County
Building Permit Application
Planning and Development Services
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
PROPOSED IMPROVEMENT LOCATION:
Address:
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IP
Project Name:
Setbacks Front Back: Right Side: Left Side:
Is DETAILED DESCRIPTION OF WORK:
Q"vYQ41 removed, insula'hon removeci, insulation replacement, &\lUx t
replacement, paint, interior door replacem>l.nt. (prywO.11 rp,pIC3.CAm LfW
up -i-o 2' Woove floor due b Poodt ni-koln 7 rma.
CONSTRUCTION INFORMATION:
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OHVAC 0 Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ c5xCO.00
Piping
UShutters
❑Windows/Doors
nklers
[]Generator
0
Roof
0
Roof pitch
S Ft. of First Floor: _
Utilities: Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name '2ihpoliar) LAC_
Name: Michael J. Waldrop
Address:_ I ld Peaac us, T)rwe
Company: Innovation Contracting, Inc.
City: _y� l l tea' State: L
Zip Code: 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
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _ Not Applicable
Name:
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1st <<.te"�l"�..R
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 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 andcovenantsthat 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 Commencer
improvemeWto your property. A Notice of Commencement must
before thei�k(rst inspection. If you intend to obtain financing, consul
nd
commene work of recordine vour Notice of Commencement. ,,
as Agent for Owner
STATE OF FL
COUNTY OF
The forgoing instrum t w ac nowledgW before me
thi day of 20by
c /
ame of person making statement
Personally Kno OR Produced Identification
Type of IdentifiBaiofi-i /
(Signature of NotfLv Public- State of Florida )
AMR A M HUFFPeaq
Notary Public - State of Florida
Commission # FF 234730
I COMPLETED
Rev.8/2/17
REVIEW
iay result in your paying twice for
:orded and posted on the jobsite
lender or an attorney before
STATE OF 11`6 A C� ) �C+
COUNTY OF L 6
The
me
`Name of person making statement
Personally Kn wn OR Produced Identification /
Type of Iden i 1 aion � J
Produced k—/ i 1�
(Signature of Noory Public -State of Florida )
ANGELA M HUFF
Notary public - Stale of Florida
MANGROVE
REVIEW