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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO) MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 7• / Permit Number: Building Permit Apl;Ciq1f p9 FED 7 2018 Planning and Development5ervices 13Y Building and Code Regulation Division St. Lucie Countv 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential Address: 3100 ST LUCIE BLVD, Fort Pierce FL Legal Description: SAN LUCIE PLAZA S/D-UNIT ONE- BLK 62 LOTS 1, 2, 3 Property Tax ID #: 1428-702-1420-000-9 Site Plan Name: Project Name: Setbacks Front Back: Right Side: Install %Chain Link Fence with(1 �' Gate Aaauwnd1 worK to oe enormea unuer tors Permit —a I]HVAC Gas Tank ❑Gas Piping 11 Electric 0 Plumbing 05prinklers Total Scl.of- of Construction: Cost of Construction: $ ra�oZ D l7 Gate Lot No. Block No. LeftSide: Shutters Windows/Doors Generator 11 Roof = Roof pitch S Ft, of First Floor: _ Utilities:11 Sewer Septic Building Height: OWiUi3%LESSEE K aG, c`_ CQNTRACTOR Name Northside Christian Fellowship Name: Roderick Waller Address: Company: Sunrise City CHDO Inc. City: Fort Pierce State: FL Zip Code:-34946- Fax: - Phone No. 802-280-5472 Address: 3550 Okeechobee Rd City: Fort Pierce State: FL Zip Code: 34947 Fax: 772-907-0420 Phone No. 772-201-2850 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: rodwallerl@gmail.com State or County License: CGC1515114 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. I'�A:�G>`C;•N � �UCT(Ol��`lE[`� fA1��I1Fr3�t�itl�4i[€�,I`� ��� �NGINEER: Q Not Applicable e Christian Fellowship imm7n MORTGAGE COMPANYNot Name: Applicable 5T U1CIE BLVn, Fort Pierce FL Address: State: Phone City: Zip: Phone: State: FEE SIMPLE TITLEHOLDER: O Not Applicable Name: BONDING COMPANY: Name: QNot 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 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 to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencine work or recordine vour Notice of Commencement l���-Q L- UJ � ��� - Signature of ontractor/Licen a Holder Signature of Owner Les t- e/Contractor as Agent for Owner STATE OF FLORIDA STATE OF FLORIDA COUNTY OF St Lucie county COUNTY OF St Lucie County The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 6th day of February 2018 by this 6th day of February 2018 by Roderick Roderick Waller Name of person making statement Name of person making statement Personally Known X OR Produced Identification Personally Known X OR Produced Identification Type of Identification Type of Identification Produced Produced (Sig ature of Not ry , : .i,�tate of �� A HARRIS (Signatu a Rr; QQary u IL HA I Commis �� :� MY COMMISSION # FF(9�g1(13 Commission No. - MY COMSSJ�ptV # FF997093 •.••w ,,' EXPIRES May 30, 2020 '• �•• EXPIR S Mo�llly 30, 2020 Nei) 38H-0153 oar iii;are� FbrNeNomryServrce.com F�oriCa oWrySemw cm REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17