HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3- IJ 4e SCANNED Permit Number: 1 IiU 3 0%e6
BY
St. Lucie County
RECEIVED
Building Permit Application MAR 15 7010
Planning and Development Services
Building and Code Regulation Division permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County
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 III
PROPOSED IMPROVEMENT LOCATION: ' =.
Address: 321�,Av2 D Ft Pierce FL 34947 35OD A tJe—
Legal Description:
Property Tax ID #: 24082110 LfM — bbb — ()IF ) I —()pU I Jr Lot No.
Site Plan Name: Block No.
Project Name: Family Dollar
Setbacks Front Back: Right Side: Left Side:
I'DETAILED DESCRIPTION OF WORK`. ham,,
awning G�n.�cas ct f..Dir. i r. o� O►t e4eLx,? V� E� i -SE eA_ Q On Qr6
�oL,c;�-h P�2e��.Pr�onU
CONSTRUCTION INFORMATION:
HVAC LJ Gas Tank UGas Piping
Electric 0 Plumbing []Sprinklers
Total Sq. Ft of Construction: -
Cost of Construction: $ 6000
Shutters ❑ Windows/Doors
Generator 0 Roof = Roof pitch
Sq. Ft. of First Floor: _
Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
-NameFamily-D011s - -
-Name: Mark Walton
Address:
Company: Walton Inc
City: Ft Pierce State:FL
Zip Code: 3447 Fax:
Phone No.
Address: 661 Beville Road
City: S Daytona State: FL
Zip Code: 32119 Fax: 386-238-1300
Phone No. 386-238-1711 Ext 106
E-Mail:
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: cdaggett@southerneasternlgihtingsolutions,com
State or County License: EC13003609
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLFEMENTALCONSTRl1CTI0N
tII N LAU1/ INFORMATtOt'
` =� �`;
T GY ill S tti }
.'•
�.. vo rvY
.. v 4e u _
} 0.
4 , Ytdi. e:.Yi^ ..2 'T•W•SA t
.. }
,p�
.'�..s.,Fi`$ .!%�. e . 4YiW ..'::S°f} e�.�f%s c �,rc.Wl.� •N a
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: Family Dollar
Name: Mark Walton
Address: 3214 Ave D Ft Pierce FL 34947
Address:
City: Ft Pierce
State:
City: S Daytona
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address:661 Beville Road
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
commencing work or recording your Notice of Commencement.
Signature of Owngrl Lessee/Contractor as Agent for Owner
Signature of Cont r r/Lt
STATE OF FLORIDA
STATE OF 5 ORIDA
COUNTY OFBrevard
COUNTY OFBravard
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 13 day of 3 .20_ b1
this 13 day of 3 .20_ by
Raymond Bums o a
0 9 n d.
Mark Walton — ao r a
Name of person making statement s ` ^ ^
Name of person making statement
N = b
Personally Known x OR Produced Identif �c#t maPersonally
Known x OR Produced Identifi
t" & v
Type of Identification 15 ` <
o
Type of Identification
:
n
Produced :E E e
Produced
d
i' E E S
B
�qVV
Z V Z
O y
V�
Z Z
2Z
• � m
✓'V
(Signature of Notary Public -State A Florida
(Signature of Notary Public -State of Florida) `°
. O.1• • �
Commission No. (Seal) y ; s;
N ..
J'............
Commission No. (Seal
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
'/0 �Y
COMPLETED
Rev.8/2/17