HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �- SCANNED �b ll���
j BY
Permit Number:
St. Lucie County RECEIVED
Building Permit Application 1AN 14 2919
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
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 - I
Address: 6144 S US Highway 1 Ft Pierce FI 34982
Legal Description: White City S/D 10 36 40 Lot 266 - LESS N 550 FT and LESS RDS AND CANALS
Property Tax ID #: 3403-502-0349-100-6
Site Plan Name: BUDDYS HOLIDAY MOBILITY
Project Name: BUDDYS HOLIDAY MOBILITY
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE IMPACT STORE FRONT SYSTEM
CONSTRUCTION INFORMATION:
Lot No.266
Block No.
11HVAC
11GasTank
E]GasPiping
0
Shutters
❑✓
Windows/Doors
Electric
1:1Plumbing
Sprinklers
1:1Generator
Roof
=
Roof pitch
Total Sq. Ft of Construction: 600 sf of Window
Cost of Construction: $ 50,000.00
5 Ft. of First Floor: 2800 SF
Utilities:IZSewerF]Septic Building Height:12'
`OWNER/LESSEE:
CONTRACTOR:.
'NameACTIVE MOBILITY AND DESIGN iNC.
.Name: MICHAEL J WALDROP
6144 S US HWY 1
"Address �
`Cempanyr INNOV/LT,,ION CONTRACTING INC
City: FT PIERCE State:FL
Zip Code: 34982 Fax:
Phone No.
Address: PO BOX 12757
City: FT PIERCE State: FL
Zip Code: 34979 Fax:
Phone No. 772-519-9108
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: MWALDROP@INNOVATIONCONTRACTING.COM
State or County License: CGC1511910
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENIALC-ONSTRUCTIONryL,IEN,LAW
INEOR�VIATION�
DESIGNER/ENGINEER: _ Not Applicable
Name: Ayfr-hifec 16n1CS
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: bo(, 7)e1ewrre AysE
Address:
City: aFTP.ie�c _ Stater
Zip: 3yy t-L� Phone 771- - yGa- '7 2T l
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address: Po Box 12757
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 OW R: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements ur erty. A Notice of Commencement must be r9e9rded and posted on the jobsite
before the fir sp Ion. you intend to obtain financing, consult vtlytender or an attorney before
commenci ork r 1eco Ins vour Notice of Commencement.
JI
tur essee/Contras or as Agent for Owner
L e
der
7TATEOF FLORIDA
rATETOF0FLORIDA
COUNTY OF L , I y( SZ
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The forgoing instrument was acknowledged before me
0,
The forgoing instru rent was acknowledge before me
this day of 20jg by
this ay of
by
b[Y� ld(oP
Name of person making stat ent -
Name of person making
stat ment
Personally Known 4 OR Produced Identification
Personally Known -,&_ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
o'••,
(Sign ture of Notary li fl4,jd��bumic-sU[e of noada-
(Slgnat reof o ublic-
to dio Florida) KRISTYSE%TON
Commission p GG 206744-.'
Commission No. 1?orF`°�- My(5*W) Expires Apr 17, 2022:
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-Commission No� vb 7�
• �� Notary Public - State of Florida
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My Expires Apr 17, 2022
Bonded through National Notary Assn.
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Bonded through PAo'nal Notary Assn.
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1 '6110
Rev.8/2/17