HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_ �2 J19- 2-0 LS Permit Number:MO
-M RECEIVED DEC 18 2015
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 XXX Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRyOPOS,ED 111/IPROVEMENT,LOCAI-ION y =_� 5.'4 = ���
Address: 5500 Saint Lucie Blvd. Fort Pierce, Florida 34946
Legal Description: 30 34S 40E 30 34 40 Beg at SE Cor SW 1/4 of SW 1/4 Run W on S li of SD SW 1/4 of SW 1/4
333 Feet, Th N to PT on Li of SW 1/4 of SW 1/4 331.2 feet W of NE Cor of SW 1/4 Continued on Tax Roll
Property Tax ID#: 1430-331-0001-000/8 Lot No. L7— 6
Site Plan Name: Road Runner Travel Resort Block No.
Project Name:
Setbacks Front Back: r5 Right Side:Left Side:�L
DETAILED D�E`SCRIPTION OF WORK ` ' � � �� '�
T t
Install 'S'foot X 8'fcot Shed DCA [o y S q
CONSTRUCTION INFORMATION'`
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Additional work to be pertormed under this permit-check all that appy:
HVAC Gas Tank E]Gas Piping _Shutters Windows/Doors
11Electric ❑_Plumbing 'Sprinklers ❑Generator E] Roof
Total Sq. Ft of Construction: ( Sq. Ft. of First Floor:
Cost of Construction:$ Zt7i100 00 Utilities:[]Sewer Septic Building Height:
01NN$ER/LE'is SEE r, CONTRACTOR '�
µv
Name Marilyn MinixName: Lori Williams
Address: 5500 SaintUcie B,IVii. Company: D & M Concrete Constuction Inc.
City: Fort Pierce State: FI Address: 331 Sunrise Dr.
Zip Code: 34946 Fax: (772)464-0987. City: Fort Pierce . State: FL
Phone No. (772)464-0969 Zip Code: 34945 Fax:
E-Mail: sean@roadrunnertravelresort.com Phone No. (772)465-4355
Fill in fee simple Title Holder on next page (if different E-Mail:
from the Owner listed above) State or County License: #24764
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL'CONSTRUCTIOULIENLAW INFORMATION'
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable .,_.
Name: Name:
Address: Address: _
City: State: City: State:
Zip: Phone: Zip: Phone:
FEESIMPLE 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 with lender or an attorney before
commencing work or recording our Notice of Commencement.
S
_Sig ature of(6wner/Lessee/Agenf Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STS G� COUNTY OF �-
�• Lu -Q,
The forgoing instrument was acknowledged efore me The forgoing instrument was acknowledged before me
this /0 day of bECW� 20 I?by this day of tW Qe'Ylbe 2-016-by
W AtR-V1L) M IPr1- W k t���I�S
(Name of person acknowledging), n , (Name of person acknowledging)
Na�'� 06 LOAQAd
(Signat re of Notary Public-State of Florida) (Signature of Wotary Public-State of Florida)
Personally Known ✓ OR Produced Identification Personally Known tel OR Produced Idenitification
Type of identification
,P^roduced T.
��p��{�y� 77 pe of Identification
�Pro (coed
/� _/'�� ]l/ SPpY P 11`I I HIA D� {-!'�1 G�J ss% j}�,_
Commission No. 7�/ V �4 �e c�NwssloN#FF231 aC mmission No. '�fif�j• YN 0 DRAM
EXPIRM&June 29,2019 '� M1"COAWMISSION P FF198
oF� EXPIRES Fahhwy 20,
�' N@� ' 1q I1oN�q�1� �evbeaos
Revised 07/15/2014 `
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS