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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: `� �•� f 14 PermitNumber: Eft SCANNED - I BY 0.ECEIVEx° c _ St. Lucie County Mpy - Building Permit Application alcme"L Planning and DevelopmentServlces perming 0 �untY Building and Code Regulation Division sty l note 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Other ra 41 PROPbSEDIMPR01/-Mf-,NTLOC TI©V 1,� F �� }_b.',,T, ";', I ,'I"f i„'�<� k� Address: 5101 NA1A, FT PIERCE, FL 34949 Legal Description: 15 U40 THAT PART Or N SW FTOF SEC LYa WOF ELY MHW U OF BLUE HOLE CREEK (30.00AC)(OR 1M2470; 317&2M Property Tax ID #: 1415-111-000"00-5 Lot No. Site Plan Name: SLC MOSQUITO IMPOUNDMENT 19B Block No. Project Name: Setbacks Front Back: Right Side: Left Side: INSTALL CROSSOVER WALK E3HVAC FIGasTank Ei GasPiping ❑_Shutters ❑Windows/Doors Electric 0 Plumbing L ,JSprinklers El Generator 11 Roof Total Sq. Ft of Construction: Cost of Construction: $ 4,000.00 S Ft. of First Floor. _ Utilities:llSewer ElSeptic Building Height: Roof pitch r n Y.,, irtvnn ( ST11 ), r ��at `���1'l) ..d!'�:�d a na G,_s .. F CONIIdRAC�'OR•�}'�iai�')iti ..%h.. �'�+ 17-Sic tLn � ,�I�✓R �tiilj,�`��9l,j;l,�� PSif t Iii , I �k)'�, .y�- Name 'eso +. -op Name:^IOYSYANCY Address: 5101 N A I r-i Company: SUMMERLINS MARINE CONSTRUCTION City: Y i E- Zip Code: 34Q9 Fax: Phone No. State: ,J_L Address:,?00 NACOE RD, SUITE C City: FT PIERCE State: FL Zip Code; 34946 - Fax: 772-464-7470 Phone No. 772-464-6090 E-Mail: - Fill In fee simple Title Holder on next p4ge'(if differerit from the Owner listed above) E-Mail: SUMMERLINSMARINECONSTRUCTION@GMAIL.COM State or County License: 24217 ie of cgnstr4cti nTs $2500 or'more, a: RECORDED: Notice of Commencement Is required. SUPPLEMENTAL CONSTRUCTIQNiLIEN LAW IVFQRIVIATION E t # a i d;a� I . ' { i`'il l'`t„ DESIGNER/ENGINEER: _ Name' eo HrrCHNSON Not Applicable MORTGAGE COMPANY: Name' _ Not Applicable Address:2705 N iNDuw RIVER DR Address: City: "PIERCE Zip: 39W Phone--263`-1399 State: R City: Zip: Phone: State: _ FEE SIMPLE TITLE HOLDER: _ Name: Not Applicable BONDING COMPANY: Name: _Not Applicable Address:2Do NACOE RD, Sur E C 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. certify that no work or installation has commenced prior to the issuance of a permit. - no the permit holder to build the subject structure r and covenants that may restrict Or prohibit such aed 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 uour Notice of Commencement. ignatuQD O Vn ---t• ee/Got aato a .gent ar Owner Signatu a of ontra or/ ' ense Holder STATE Or FLORIDA `�rF"• L L' t STATE /F FLO /� T LU COUNTY OF COUNTY OF C, 12. The forgoing instrument wqs acknowledged before me The fo,[�oing instrument as acknowledge before me I(I this a day of f_�{ 1� 20}� by this day of jal�C 1� 20� by H Ard N."j'i ion JOY SYANCY Name of perso aking statement Name of person making statement Personally Known V OR Produced Identification Personally Known x OR Produced Identification Type of Identification Type of Identification Produced Produced (Si t o o (Signature of Notary P �'.'� to ofIkR p RESTER .:*t:°v�••. SUSAN BELLAMY es ission No. = ission #Md01056 FF9129 '�` MYION p FF912939Co Commission No. 1t_ Fu Expires January 26, 2019 st 25, 2019'..-" ••46 •'9uIC911399-0153 rise Ys.mr. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW RE REVIEW REVIEW REVIEW DATE RECEIVED �141 i DATE COMPLETED S Rev.8/2/17 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 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 Residential PERMIT APPLICATION FOR: Other PROPOSED IMPROVEMENT''LOCATION:. I,H I.,J;'i;I, ii Address- 5101 N A1A, FT PIERCE, FL 34949 Legal Description: 15M 40 THAT PART OF N 550 FT OF SEC LYG W OF ELY MM U OF BLUE HOLE CREEK(30.00AC)(OR 11&2470; 3175- 95 Property Tax ID q: 1415-111-0001-000-5 Lot No. Site Plan Name: SLC MOSQUITO IMPOUNDMENT 19B Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DES_CRIPTIgN OF -WO RK INSTALL CROSSOVER WALK CONSTRUCTIQN INFORMATION: AacitionalworKTODenerformed under tis permit— cec all apply: ❑ ❑HVAC Gas Tank []Gas Piping _ Shutters Windows/Doors ❑ Electric Plumbing ❑Sprinklers ❑ Generator ❑ Roof ❑ Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ 4,000.00 Utilities: Sewer ❑Septic Building Height: OWNER/LESSEE: I{ CONTRACTOR 'j l ' Name Name: JOYS VANCY Address: Company: SUMMERLINS MARINE CONSTRUCTION City: State: _ Zip Code: _ Fax: _ Phone No.- Address: 200 NACOE RD, SUITE C City: FT PIERCE State: FL Zip Code: 34946 Fax: 772-464-7470 Phone No. 772-464-6090 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: SUMMERLINSMARINECONSTRUCTION@GMAIL.COM State or County License: 24217 II;If value of'coristrdWon is $2500 or more, a RECORDED Notice of Commencement is required. II