HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO S +BE CQ1 IMPLLETED FOR APPLICATION TO BE ACCEPTED
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Date: I �1�' 1 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
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SCAN8y
NED
St. Lucie County
Commercial Residential
PERMIT APPLICATION FOR: Renovation i II
PROPOSED INPROVEMENT LOCATION:
Address: 8280 Business Park Drive Port St Lucie FL 34952
Legal Description: St Lucie Business Park Lot 10 (1.57AC) (OR 1807-2363)
Property Tax ID #: 3426-702-0011-000-2
Site Plan Name: Good Samaritan Ministries
Project Name: Good Samaritan Ministries
Setbacks Front Back:
DETAILED DESCRIPTION OF WORKi
CONSTRUCTION INFORMATION:
Right Side: Left Side:
Lot No.10
Block No.
HUUILIUIIdI WU1K LV UC enunucu u11uc1 uub Pcuun—uie�n an apply.
ZHVAC Gas Tank [--]Gas Piping _Shutters ❑Windows/boors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Constructiot� % S Ft. of First Floor• 8 026�
Cost of Con structtio40n: $ I� j ��� Utilities:Sewer Oseptic Building Height:
OWNS /LESSEEr`
CONTRACTOR
Name St Lucie Business Park LLC
Name: William B Jones
Address:2240 Woolbright Rd 9300
Company: Freedom Homebuilders Inc
City: Boynton Beach State:FL
Zip Code: 33426 Fax:
Phone No.
Address: 1084 NE Industrial Blvd
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 772-634-0580
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: ACAJQQYx96 (vcrq ears
-State or County License: 27529
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
4
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIONi I I
DESIGNER/ENGINEER: _ Not Applicable
Name: Jahn Foster
Address: 11205 Ridge Avenue
City: Fort Pierce State: FL
Zip: U982 Phone: 772-370-9464
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: V Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: JNot Applicable
Name:
Address:
City:
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 yvilender or an attorney before
commenciryg work or recor¢i1t�q�Notice of Commencement.
n k / 1 //
Agent/
STATE OF FLORIDA COUNTY OF � / �UCJG
The forgoing instrument was acknowledged before me
this 4t' lay of /-17✓ C 20U by
�1
(Name of person acknowledging )
of
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this /Adayof 14Ls 20120by
Personally Known ✓ OR Produced Identification Personally Known
Type of Identification Produced Type of Idenrtifitatyul.pl
Commission No.
Revised
53
KkelaV M PHILLIPS Commission
MY COMMISSION #FF043972
OR Produced Identification
KELLY M PH LIPS
M1`E6MMISSION �3972
EXPIRES September 29. 2017
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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