HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED '1
Date: 8/13/15 Permit Number: 0Jr ocX33•
71= RECEIVED
Building Permit Application AUG 14 1015
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 x Residential
PERMIT APPLICATION FOR: Demolition
PROPOSED IMPROVEMENT LOCATION: -
Address: 3255 S US HIGHWAY 1 FORT PEIRCE FL.34982
Legal Description: MARAVILLA GARDENS S/D-UNIT THREE-S 95 FT OF E 400 FT OF N 210 FT OF LOT 180(OR 2788-483;3560-2511)
Property Tax ID#: 2427-601-0055-010-5 Lot No.180
Site Plan Name: MOTI Block No.
Project Name: ACTION DEMO
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INTERIOR DEMOLITION: Remove Sheetrock and paneling from wall and ceiling and secure all
utilities and mechanical sites as per code
CONSTRUCTION INFORMATION:
Additional work to be nertormed under tis permit—cleck all appy:
HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
Electric Plumbing Sprinklers 11 Generator E] Roof
Total Sq. Ft of Construction: S'C Ft.of First Floor:
Cost of Construction:$ S 0. Utilities: Sewer Septic Building Height:
OWNER/LESSEE: 1 CONTRACTOR:
Name Moti N Ramgopal(TR) Name: LEONARD GRAHAM
Address:5476 SW Longspur Ln Company: LEONARD GRAHAM INC.
City: Palm City State:FL Address: 3360 SPANISH MOSS TERR#201
Zip Code: 34990 Fax:7727774937 City: LAUDERHILL State:FL
Phone No.9542750797 Zip Code: 33319 Fax: 954.733.8814
E-Mail: Phone No. 954.326.8061
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CGC1521903
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: N/A Name: N/A
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 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 h lender or an attorney before
commencing work or recording our Notice of Commencemen .
44/wL��
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Signature of Owner/Lessee/Agent Signa ur .,f o.ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 13 day ofl�JL 20 <S by this day of Y 20 by
AA(Name of person cknowledging) (Name of pers n acknowledging)
(Signature of Notary Public-State of Florida) (Signature o Not /ublic-State of Florida)
Personally Know!IMF� Personally Known J OR Produced Identification
Type of IdentificDAVID S.T-I Type of Identification Produ
DAVID S.THOMAS
Commission No. Commission No. MY Cq%0ION 0 FF 181287
,W EXPIRES:December 04,2018
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS