HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater rl 9 �I•I� SCANNED Permit Number:
BY
t _ St. Lucie County
RECEIVED
Building Permit Application
Planning and Development Services MAY 2 9 2019
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION: '=�
Address: 904 Prima Vista Blvd., Port St. Lucie, FL 34952
Legalp RIVER PAR - T 3-S CON REPLA - L POR ION C A D DONE OL DESC L: B G T
28 DD s rMIN 00: ON NLY LI OF TRACT A WHICH BEARS S 62 DEG 22 MIN 00 SEC W 247.82 FT FROM NE COR THEREOF, THS
LI OF TRACT A (2.04 AM (MAP 3412251 [OR 3570-1241) 1 924 PRIMA VISTA BLVD. PORT ST LUCIE FL
Property Tax ID #: 3419-525-0001-100-5 Lot No.
Site Plan Name: Block No.
Project Name: Indian River Holdings, LLC
y Setbacks Front Back: Right Side: Left Side:
DETAILED DESCR'IPTIOWOF�WORK:
EMERGENCY LEAK REPAIR
1!
CONSTRUCTION INFORMATION:`
i iona wor o e e orme un erthis permi — check a apply:
[at
1JHVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
0
Electric Plumbing Sprinklers ElGenerator Roof Roof pitch
H--0
Total Sq. Ft of Construction: Sv S Ft. of First Floor:
Cost of Construction: $ 12,000.00 Utilities: �Sewer El Septic Building Height:
OWNER/LESSEE: ,
CONTRACTOR:
Name Indian River Holdings LLC
Name: Whiting Construction, Inc.
Address: 309 SE Osceola Street
Company: Whiting Construction, Inc.
City: Stuart State: FL
Address: PO Box 1908
Zip Code: 34994 Fax:
City: Palm City State: FL
Phone No. 772-223-1215
Zip Code: 34991 Fax: 772-223-1215
E-Mail: wci@whitingconstruction.com
Phone No. 772-223-1215
Fill in fee simple Title Holder on next page (if different
E-Mail: wci@whitingconstruction.com
from the Owner listed above)
State or County License: CCC 033699
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
bt1JFFLtIVItN IAL CONSTRUCTION
UEN'LAW INFORMATION.
DESIGNER/ENGINEER: _Not
Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City:
State:
City: State:
ZIP: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
Name:
Address: Poao i me
Address:
City:
City:
ZIP: Phone:
Zip: Phone:
NUMEe / I A.I. A..r.....
_
- --•- • • ^ • �-•• �• • —.... „pp„canun is nereoy mace 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.
whichis Inc onflict with any applicablelHome Owners Assoclationl rulesabylaws or andpcovenants 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 work or recording our Notice of Comm----- t
en .
2x/
Signature of OWDdrl Lessee/Contractor as Agent for Owner
Signature of Contract i�e Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MARTIN
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 28th day of May 20 19 by
this 28thday of May 20jk by
Eugene Whiting
Eugene Whiting
Name of person making statement
Personally Known ED OR Produced Identification
Name of person making statement
Personally Known F11 OR Produced Identification
Type of Identification
Type of Identification
Produced \
Produced
(Signature of Notary Public-Stat of Florida I
(Signature of Not
Commission q,.:(t MUL Ey
Commission No.
• A NA MU1L�R�O�ONEY
;y;... u❑
OMMISSImtPR'GG041309
y MY COMMISSION # GG041309
EXPIRES October 24
''';r;, ' EXPIRES October 24, 2020
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60., c/')Po-r