HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,I 7�
Date: 1 g Permit Number: � " 0`f 2
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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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT:LOCATION:
Address: JSP GOL, Fcoti!-D L-Al
Legal Description: 1 Oo0 / W. A n!6L.c-!ZD
e3 35 0� N tAS 1& LeSS At-LION t4A-fJM- ! 9 • q,Z�4C/
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Property Tax ID#: p�� -�� Lot No.
Site Plan Name: _G n 1-'D E^J NQS Block No.
Project Name: S OZY)
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Setbacks Front Back: Right Sider Left Side:
DETAILED DESCRIPTION OF WORK.'
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CONSTRUCTION INFORMATION:
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Add
itiona wor to a pe orme un er t is permit-c ec a t at app y:
_HVAC _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ / o s Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name C gs Hrd Ma Sa y ame: nCA Po ivT� ���.brL:2.S
Address: F0 ii-&V 3l ICompany: J-rJ
City d m pf�lub �G`7 State:'r L Address: l 1�( QJ,ee.ti1 I UNI C-7
ZipCode: �T Fax: U-� �'� City: State: L
Phone No. Zip Code: 34ri49 Fax: N A
E-Mail: *r/& Phone No. -7 -Z-
Fill
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: C-6c.
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEM'ENTA`L CONSTRUCTION LIEN [AWINFORMATION"'
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 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
_Signature of Owner/Lessee@gent a of Con or/License Ho
STATE OF FLORIDA STATE OF RIDA
COUNTY OF (_19_4oulyC / COUNTY S4 ) .
The forgoing instrumnt was acknowledged before me The forgoing instrument was acknowledged before me
this .25day of anti 20 /by this`L, day of :]&,n .20 ZAP by
-tn�C76WCI&1
(Name of person ackno dging) (Name of person acknowledging)
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(Signature of N tary Public- tate of Flo ida) (Signature of Notary Public- tate of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced %111111 10JA'. Type of Identification Produced
4 / x iI LLEN�j,��ii� �rL$-3 -Ta9J x{3'(,0 ,,
Commission No. O /y � IDN•.;�iF�r Commission No. l( I]INA INGRAM
•�,���s114,?��/o�• "61
Notary Notary Public-State of Florida
�J ��9cn: = p ;•_M Comm.Expires Dec 20,2018
_*: ►.4 = o-;c Commission#FF 1772
Revised 07/15/2014 ��•• #FF 608137 •o� F, Bonded through National Notary Assn.
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REVIEWS FRONT ZONII
� IJIIC.11•T 4 RVISOR PLANS VEGETATION SEA TURTLE MANGROVE
1
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
EQUAL HOUSING
OPPORTUNITY
A 55 OR OLDER MANUFACTURED HOME COMMUNITY
1/15/16
Pershing Mobile Home DBA Golden ponds gives permission for Seapoint
Builders to put a building for the Golden Ponds softball team in the north east
corner entrance located beside the ball field off of Angle rd.
Park Manager
1800 Golden Ponds Drive, Ft. Pierce,Florida 34945
Phone (772) 465-8005 ® Fax (772) 595-0723 . www.aoldenponds.com