HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Yf
Date: 3 \`� SCANNED Permit Number: 1"103' 0313
BY
Lucie County
• =RZECCEIVE[D)Building Permit ApplicationPlanning and DevelopmentServices Building and Code Regulation Division 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
PROPOSED IMPROVEMENT LOCATION:
Address: 100 CYCLONE DRIVE, FORT PIERCE, FLORIDA 34945
Legal Description: S112 OF laOFW 112 OF SW114 OF NE 1A-LESSW25FTAND LESS S33FT AND LESS ADDL RD RNJMPDAF: BEG INTN RD RNVLI OF ORANGE
AVE AND E RD RIW LI OF CYCLONE OR, TH N 00 13 54 W ALG E RNJ LI 30 FT, TH N 89 1541 E 307.05 FT, TH S 00.11 17 E 30 FT, TH S 8915 41 W 307.03 FT TO POB-
Property Tax ID #: '2308-133-0001-000-7 Lot No. N/A
Site Plan Name: ORANGE AVENUE BAPTIST CHURCH Block No. N/A
Project Name: COVERED BASKETBALL COURT
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCT PRE-ENGINEERED METAL BUILDING BASKETBALL CANOPY WITH
RESTROOMS
CONSTRUCTION INFORMATION:
tlona wor to
[]HVAC
e e orme under tispermit—checka
El Gas Tank Gas Piping
apply:
In Shutters
_
Windows/Doors
Ri Electric
RIPlumbingSprinklers
Generator
R1 Roof E2 Roof pitch
Total Sq. Ft of Construction: 10,000 S.f.
S Ft. of First Floor: 10,000 S.f.
Cost of Construction:
$' 7 avi
FTv,•,•— Utilities:
G Gam,
❑�
Sewer Septic
I
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ORANGE AVENUE BAPTIST CHURCH
Name: DOUGLAS DAVIS
Address: 100 CYCLONE DRIVE
Company: RICHARD K. DAVIS CONSTRUCTION CORP.
City: FORT PIERCE State: FL
Zip Code: 34945 Fax:
Phone No. 772-519-1305
Address:
City: FORT PIERCE State: FL
Zip Code: 34954 Fax: 772-465-7665
Phone No. 772-461-8335
E-Mail: tindallcattle@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: rpriest@rkdavis.com
State or County License: CGCO13084
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
am
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: P�ULWELCH,P.E.
Name:
Address: 1984 BILTMORE STREET, UNIT 9114
Address:
City: PORTST.LUCIE State: FL
City: State:
Zip: 34984 Phone 772-785-9888
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing workorrecordingour Notice of Commencement.
(J4� a,a�
Rt ^" Z-*-�
Signature of Owner/ Lessee/Contr ctor as Agent for Owner
Signature ol Contractor/License Holder
STATE OF FLORIDq
STATE OF FLORIDA
COUNTY OF JT / //G/E
COUNTY OF Z LOG/6e
The forgoing instrument was acknowledged before me
this � day of �l�}D/.d✓ 20a by
for
The ing instrument was acknowledged before me
this day of_ _1J4A11Z Iy 20_& by
aARgMGE L.
%C1,)dVU
Name of person making statement
Personally Known K OR Produced Identification
Name of perso making statement
Personally Known L/ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
4,e
(Sig/at/re of Notary Pu
(in Kre of Notary Pr]IlStziteoLF[ciri&)]�,,oy
4 ROGER A. PRIEST
�`%': NotfliaeW8 Ilc - State of Florida
3 Commission • GG 010740
,= My Comin. Expires Nov 7, 2020
kun
No.
y1mu„- ,ROGENA. PRIESTCommission
Commission No. •s Notar&Svialo - State of Florida
Commission Is GG 010740
Yy Comin. Expires Nov 7, 2020
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Rev.8/2/17