HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �7
Date: /' � '/ Permit Number: 16-0- Oc-)O
Building Permit Application JUL
5 .2015
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 IIVlPR01/EIVIENT L0' ATION k
K l
Address: 95y AJC Sob'd-0- hr
Legal Description: P-i Ve,, l`7o-(L -(A vi A- 21 Po_0- - FA-i- `i 2 Lof -7-
PropertyTax ID#: ���C( -rj (p,�j - X022 - (inc-) - t Lot No.- 2- 1
Site Plan Name: Block No. 2-2-
Project
2Project Name:
Setbacks Front Back: Right Side: Left Side:
"-DEAILED DESCRIPTION OFWORK ` ` 3
P9," .r. �, 'E s•
Ins ,l s+Com, Va_Y\e s 1 r)
CO'NSTRUCTIQN
IN N„ _
Additional work to e errormed under this permit-check aappy: '
HVAC Gas TankGas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers 1:1 Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ r]52 UtilitiesInSewer Septic Building Height:
OU1lNERJLESSEE , Fg CONTRACTCQR *'
Name 44v1 Iu W c- U h Name: Michael ODonnell
Address: g`-]a i I)w t 12K�{'V --S+'
Company: ODonnell Contracting LLC
City: M0 r-Q�n S State: Address: 2125 SW Hayworth Ave
Zip Code: 70 i l l Fax: City: Port St Lucie State:FL
Phone No._ Zip Code: 34953 Fax:
E-Mail: Phone No. 772-408-0200
Fill in fee simple Title Holder on next page(if different E-Mail: rcodonnell3ll@gmail.com
from the Owner listed above) State or County License: 27071
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
N �EMEb 'AGQyNSTRUCTIONLIEI 1N IN' ORMATIf7N 1
SUPPL NT
r
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 its 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 work or recording our Notice of Commencement.
1 s
_ ignature of Owner/Lessee gent Signature of Contractor/License oder
STATE OF FLORIDA STATE OF FLORIDA.
COUNTY OF S-� COUNTY OF S a1 c 6 0
The forgoing instrument was acknowledged before me The fo!r oing instrument was acknowledged before me
this�day of d,,�— 20 j�by this n`o day of_I lk W 20 15 by
Ml,~�nae� c� `li��MP;I 1 �i �, D
(Name of erson ack owledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida 1 (Signature of Notary Public-State o Florida)
Personally Known_�OR Produced Identification Personally Known L,,�''ZOR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. �;Ar'py4. �)L FULLER Commission No. >"�°m�.':. (5�, E FULLER
+' MY COMMISSION#FF464558 N Q= MY COMMISSION#FF064558
Nt e' °TF..-oP,= EXPIRES October 20,2017
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Revised 07/15/201 td®��sssots3 FloridallotatyService.com (407)398-0553 FloridallotaryService.com
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