HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ff (�2 t
Date: �0 �-S Permit Number: 1510 ` l 1J1`0
RECEIVED
Building Permit Application OCT 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 X Residential
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT,LOCATION
Address: 3451 SW MIDWAY ROAD
Legal Description: WHITE CITY S/D 05 36 40 BEG AT NW COR OF LOT 100 RUN E 135 FT,TH S 659.4 FT,TH W 135 FT,TH N TO POB-LESS RD
AND CANAL R/W-(44)(1.72 AC)(MAP 34/05S)(OR 1606-1299)
Property Tax ID#: 3403-502-0192-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Florida Center for Recovery
Setbacks Front Back: Right Side: Left Side:
DETAILED.DESCRIPTION:OF WORK: ,,.
REMOVE OLD GLASS DOORS AND REPLACE WITH NEW NON IMPACT DOORS.
EXISTING ACCORDION SHUTTERS ON SITE.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—clelT appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 2,300 Utilities:Sewer E]Septic Building Height:
OWNER/LESSEE: . CONTRACTOR:
Name FLORIDA CENTER FOR RECOVERY Name: MACK MATOS
Address:3451 W MIDWAY ROAD Company: MEL-RY CONSTRUCTION
City: FORT PIERCE State:FL Address: 10967 S OCEAN DRIVE
Zip Code: 34981 Fax: City: JENSEN BEACH State:FL
Phone No.772-229-0012 Zip Code: 34957 Fax: 229-9440
E-Mail: Phone No. 229-9439
Fill in fee simple Title Holder on next page(if different E-Mail: MACK@MEL-RY.COM
from the Owner listed above) State or County License: 23630
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION-
DESIGNER/ENGINEER: x 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: 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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_Signa ure of ner/Lessee/Agent Signature of ontractor/License Holder
STATE OF FLOPAD,,A STATE OF FLOR �p '
COUNTY OF�J- . 1, 1A > COUNTY OF . ,,! u� e
The forgoing instrument was acknowledged before me The forgoing instrumeq was acknowledged before me
thiscRO.day of 20/_I!�:by this '0 day of 20 J,!�_by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) Signature of Notary Public-State of Florida)
Personally Known OR Produced identification Personally Known _OR Produced Identification
Type of dentifisatieta Type of Icrentificat'
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Y° C.SUMMERS `� 0'13 P
Commis i0 c tate o(Seal�a Commiss(On: o. •, D G. UM
My Comm.Expires Dec 19,2017 n •_ State of Florida
P;F My Comm.Expires Dec 19,2017
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Revis
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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INITIALS