HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/4/2015 Permit Number: 1
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 x
PERMIT APPLICATION FOR: ---
PROPOSED IMPROUEN)E
,NT LOCATION
M� ., .. ...
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Address: 212S.E. CELESTIA COURT/PORT ST. LUCIE FL 34983
Legal Description: RIVER PARK-UNIT 5 BLK 45 LOT 15
Property Tax ID#:
3419-540-0069-000-5 Lot No. 15
Site Plan Name: Block No. 45
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION QF"`WORK k:
t
CHANGE METER CAN AND CHANGE OVERHEAD POWER TO UNDERGROUND POWER
CQ�NSTF .UxCTION 1140RM4l IOIVx
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Additional worK to erfer orme under this permit—cneCK a appy:
❑HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors
❑Electric Plumbing Sprinklers a Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ 1500.00 Utilities: Sewer Septic Building Height:
777
f
CON7RACTOR'�
Name JAY BUNK 212 ,LLC(JAY BUNK-MANAGER) Name.
Address: 200 S.E. CELESTIA COURT Company:
City: PORT ST. LUCIE State: FL Address:_/rlrl sot
Zip Code: 34983 Fax: cry � Y S't 1_U ej z State:
Phone No.772-979-0468 Zip Code:r(q Fax: /« em"311
E-Mail. dings @ undent1.com Phone No. �Z 9 3�
Fill in fee simple Title Holder on next page (if different E-Maik-1-9 ��?
from the Owner listed above) State or County License: GdD��
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Sl1PPLEl1/IENTAL CO:NSTtl1CTION LIEN LAW FORMA" 3
..:
pp MORTGAGE COMPANY:
DESIGNER/ENGINEER: x Not Applicable x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: x 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 with lender or an attorney before
commencing work or recording our Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signa re of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF 3�__- COUNTY OF '517—
The for ping instru ent was acknowledged b me The forgoing instrument was acknowledged before me
this day of 20 this day of 5S � 9/9- 20 /�by
(Name of person acknowledgin ) (Name of person acknowledging)
(Signature of tary Public-State of Florida) igna r r ublic-State of Florida)
01 y A,
Personal) ��d Identification Perso n a I e tification
Type of I enti��, t,No� Produc Type f 9• •tjpn
;�_�• �`�: Notary Public-State J��11 F�IQ((fda - %°;°;�a� My COMM.
fss�4n ate of Flo
Commis a�i� ••= Co ►sslan N FF29�P3b Comm o.�q E p �Ma?3973� � )
My Comm.Expires May 27,2019 ru°9h IJationa�N�r�7,201 g
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS