HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONf .
,,All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Permit Number: (CIO-6—UljAr)_t
SCANNED
BY
f 7-� St. Lucie County RECEIVED
•
• - MAY 0 7 1019
Building Permit Application
Permitting Department
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMITTYPE:
PR@POSED,,IMPRO,VEMENT LOCATION
Address: 3040 W Midway Road Ft. Pierce, FL 34981
Property Tax ID #: 3405-133-0001-000-8 Lot No.
Site Plan Name: Block No.
Project Name: FL 1791 Midway Road Church of Christ
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tiCONSTRUGTION�INFORMA,T�ION ' � <.
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters -Windows/Doors
Electric — Plumbing _ Sprinklers _ Generator _ Roof 5-- PPabu
Total Sq_Ft_of.Constructio_n�/��6 Sq. Ft. of First Floor:
Cost of Construction: $ 99,600.00 Utilities: Sewer —Septic Building Height:
OWNER%LESSEE-:j.,
C@NTRACT@R-
Name: Francis Buchanan
Name Midway Road Church of Christ
Address: 3040 W Midway Road
Company: Buchanan Services, LLC
City: Ft. Pierce ' State: _
Address:1111 SE Federal Hwy Suite 124
City: Stuart State: FL
Zip Code:34981 Fax:
Phone No. 772-461-8147
Zip Code: 34994 Fax: 772-324-8090
E-Mail:
Phone No 800-379-0122
Fill in fee simple Title Holder on next page (if different
E-Mail accounting@pdrhelps.com
State or County License CCC056685
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPL MENTAL CONSTRUCT
LIEN.LAW
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11 q
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DESIGNER/ENGINEER:
Name:
x Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
Not Applicable
47
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT"
Signature of Owner/ Lessee/C-ontractol:asAge 1Ltfor Owner.,
STATE OF FLORIDA
COUNTY OF Macon
The forgoing instrument was acknowledged efore me
this 22 day of April 201ty
Francis Buchanan/Contractor as Agent for Owner
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Public -
Commission No. GG 179975
State of Flonoa
emission GG 179975
0129/2022
STATE OF FLORIDA
COUNTY OF Martin
The forgoing instrument was acknowledgebefore me
this 22 day of APnI 20 by
Francis Buchanan
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification
f otar Public-Sta of.6fOra ajotarypulliicstateof
f NSF. Kelly Zaso
No. GG 179975 �«ti�,`�S�1y Gommmion GG 1
s01282022
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