HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONA
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED nn
Date: 2/28/2018 Permit Number:1�
• -- � Building Permit Applicatio MAR 0 6 2018
Planning and Development Services ST. Lucie 699fl€yr P@ff
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial xx Residential
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEMENT LOCATION:
Address: 13821-13825 S. INDIAN RIVER DR., JENSEN BEACH, FL 34957
Legal Description: RESD OF 91IM741 FROM SE CORSEC 9 RUN N ALG E SEC LI 900 FT MIL, TH ELY TO W RM INDIAN RNERDR AND POB
Property Tax ID #: 45OM01-0015-000-1
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK;
Right Side: Left Side:
�L er�-- 5�'c•l-ec--S-es
lttCGV6s vcCT Z t�C� to
'CONSTRUCTION INFORMATION:
AaaluonalworKLODe erTOrmea unaer inls permit - CI
DHVAC Gas Tank Gas Piping
Electric LJ Plumbing []Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 3, C9mQ
Lot No.
Block No.
Shutters Windows/Doors
Generator Roof = Roof pitch
S Ft. of First Floor: _
Utilities Sewer Septic
Building Height:
O.W N ER/LESSEE:
CONTRACTOR:
Name INNER HARBOUR PROPERTIES LLC
Name: MICHAEL MOTTO
Address:770 SE INDIAN ST
Company: SOUTHERN BUILDING ENTERPRISES
--City:STUART __-_-State:FL. —
zip Code: 34997 Fax:
Phone No.954-278-0009
Address:-812 SELINCOLN ST --- — -
City: STUART State:FL
Zip Code: 34994 Fax:
Phone No. 772-219-8005
E-Mail:BHILL@TREATMENTLLC.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: MIKE@SOUTHERBLDG.NET
State or County License: CGC1515502
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Na
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: 812 SE LWCOLN ST
City:
Zip: Phone:
Name:_
Address:
City: _
Zip:
BONDING COMPANY: _Not Applicable
Address:
City:_
Zip:
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
commencing work or recording Your Notice of Commencement.
Sign re of Owner/ Lessee/Contractor as Agent for Owner
Signature of Cont/actor/License Holde
STATE OF FLORIDA
COUNTY OF S--• Lue�`r
STATE OF FLORIDA ))
COUNTY s� Gt/0
OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this I day of (yorck 20A by
this I day of Amick 20-& by
4Ve1"
0 t�R—f
Name of pe son making statement
_moo„ w �" <
Name of person making statement
Personally KnownOR Produced Identif
atieb n
Personally Known OR Produced IdentificatType
of Identification
c
Type of IdentificationProduced
m • S
Produced6EEE(Signature
of No ary Public -State of Florida )
_ " " 9
(Signature of Notary Public -State of Florida ICommission
No. rF `130gK0 (Seal)
"":'�•,,
�6,`_
Commission No. Y3091o8 (Seal)
;
III11\1\\\\•
�
,�III,1111\\\\\
REVIEWS
FRONT
ZONING
R\
PLANS'
VEGETATION
SEA TURTLE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
Y/,Z
COMPLETED
Rev.8/2/17 \ V /