HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: a SCANNED Permit N ber�KMXL
1 _ BY � �'
St . Lucie County
Building Permit Appl
AUG 2 0 2018
Planning and Development Services
Building and Code Regulation Division /[!',t.,&u
mitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 ,V/ I COUnty, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial �n Il
PERMIT APPLICATION FOR: Aluminum with concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 3660 W Midway Road Ft. Pierce FL 34982
Legal Description: White City S/D 05 36 40 from nw cor of lot 92 run E alg N LI 235 ft forpob, th cant E 210 ft, th S/with W lot LI 632.02 ft MIL to
N RM midway rd M w 39=2ft, N n444521 w45.22 ft m no on My 162.55 ft MI th a 200 ft, tin nMit, w lot U 409 ft to pod less midway no r&(3.92AC)(map 3 sn) or(281E35, 631-1453. 6431591)
Property Tax ID #: 3403-502-0156-100-6
Site Plan Name:
Project Name:
Setbacks Frontsue- y Back:
DETAILED DESCRIPTION OF WORK:
Right Side: /36•1�1 LeftSide: —d/!f—
Lot No.
Block No.
Covered Patio Walkway r7 !i/irri �� n
L-1 a21 � T T ik�
CONSTRUCTION INFORMATION:
Additionalworl(toUffirtormedunder tispermit—check all apply:
E1HVAC Gas Tank Gas Piping _ Shutters W' dows/Doors
Electric 0 Plumbing Sprinklers Generator _ Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ ������ Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Liberty Baptist Church
Name: Gary Whigham
Address: 3660 W Midway Road
Company: South Florida Aluminum Products
City:, Ft. Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-461-2731
Address: 4807 So US Hwy 1
City: Ft. Pierce State: FL
Zip Code: 34982 Fax: 772-466-1074
Phone No. 772-466-0913
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: sfapbooks@soflalum.com
State or County License: ,T9 7.3
it value of construction Is %Z5u0 or more, a RECORDED Notice of Commencement is required.
T
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name: /f SA J6cunt Sc ..
_ Not Applicable
�ac.�—
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: NYot 1/1
Address:
City: 5MAI inn /E
Zip: Phone_
State: jill
p q76
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not 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 in io u intend to obtain financing, consult with r or a ttorney before
commencin , rk cordi our Notice of Commencement.
Sig of Own a ee/Contractor as Agent for Owner
Signature of Contr icense Holder
STATE FLORIDA
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COUNTOYOF.St:.
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The for instru¢ment was acknowledged����t�}efore me
The f r Instru ent was cknowled ed fore me
thi ay of J (.,UST ,20Y
this 1 of JS 20 y
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G62ry 16-hA�,,
ame of person m king statement
person
Name f perso aking statement
Personally Known Produced Identification
Personally Known I�OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signature of otary Public- State of Florida)
(Signature
f otar Public- State of Florida )
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^ MY COMMISSION t{ FF953138
SIGN q FF7T,)a
•'%ro,yd' EXPIRES January 24. 2020'•
,ah„• EXPIRES January 24. 2020
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Rev.8/2/17