HomeMy WebLinkAboutBuilding Permit Application 1
ALL APPLICABLE INFO MUST B COMPLETED FOR APPLICATION TO BE ACCEPTED G� 015Date: r f Permit Number: W
J 'G
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 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION
Address: 010(4 eago,yo. TY'• "�6(t -1 Lt, 34000 !X
Legal Description: Indian 'diver Gs�awS- 1111il 000 - LflfS IIJ9 Anl 1� �Yh w 3yIl2,sl
01z. sip]-aa5s: tOLm -toLts
Property Tax ID#:3409- Ie i0 -b S5r4-0oo- 3 Lot No. 16) /7
Site Plan Name: Block No.
Project Name: wi k0y) - 06,96t01d 1
Setbacks Front Back: Right Side: Left Side:
DETAILED
'R IN
DESCPTIOOF
CONSTRUCTION tNFORMATI"ONPl
Additional work to be ertormed under tis permit-check a appy:
HVAC Gas Tank Gas Piping _Shutters windows/Doors
Electric 0 Plumbing Sprinklers ❑Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 341(0,00 UtilitieslnSewer Septic Building Height:
OWNER/LE55EE r CONTRACTOR
Name 6AY-e✓l ty i ISCA Name: Boysie Ramdial
Address: 10('6,12aya_ Dr Company: The Home Depot At Home Services
City: nrl ?I le(Ge. State:FL Address: 674 S Military Trail
Zip Code: 34(h4--1- Fax: City: Deerfield Beach State:FL
Phone No. Zip Code: 33442 Fax:
E-Mail: Phone No. (954)379-1500
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CRC046858
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LI-ESN'-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: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 thepermit 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 work or recording our Notice of Commencement. "
Signature of Owner/Agent/Lessee Signature f Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 0 COUNTY OF Sf L uc
The forgoing instrument was acknowledged b fore me The forgoing instrument was acknowledged before me
this�day of !��y 20 l!by this X day of ?'/?may 20_S by
Boysie Ramdial 1 Boysie Ramdial
(Name of person ac l g) (Name of a g
(Sign re of ublic-State of Florida ) (Siprrature o Notary Public-State of Florida )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. tut � THONALLENTH Bmmission No. �Seal�
NOTARY PUBLIC MIR JO ATH N ALLEN THOMA6
_STATE OF F NOTARY PUBLIC
j Comm#FF055234 TATE OF FLORIDA
Revised 07/15/2014 *CE JSJ Expires 9/18/20'17WEISI'C�'Expires9/
Comm#FF055234
18/20 7
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS