HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED nn
Date: _�;3cam_) la Permit Number:
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Building Permit Application .
Planning and Development Services WR —2 201 6
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: To Select from dropbox, click arrow at the end of line
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PRY POSED IMPROUEMENT�LOCATION
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Address: 3255 S. US Highway One Fort Pierce, Florida 34982
Legal Description: Maravilla Gardens S/D-Unit Three-S 95 FT of E 400 FT Of N 210 FT of Lot 180(2788-483;3560-2511)
Property Tax ID#: 2427-601-0055-010-5 Lot No. Igo
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAI�Ep DESCRIPTION OF WORKX Y ,
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Demolish Building 1 of 2.
1 Story 4,604 SF, 1940 CB Stucco, flat roof building.
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CONSTRUCTION INFORMAT10111 4
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Additional work toe Derformed under this permit—check all that appy:
❑HVAC Gas Tank ❑Gas Pig Shutters ❑OGenerator
Windows/Doors
pin11 Electric ❑Plumbing Sprinklers tEIRoof
Total Sq. Ft of Construction: 4,604 S . Ft.of First Floor:
Cost of Construction:$ �� DOO, Utilities,-'n ❑Septic Building Height:
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OWNER/LESSEtEr ,x ,x , r 5r+4t r CONTRACTOR ,f f a uy
NameMoti N. Ramgopal Name: Charles A. Perry III.
Address:5476 SW Longspur Lane Company: St. Lucie Site Development, Inc.
City: Palm City State:FL Address: P.O. Box 1132
Zip Code: 34990 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34954 Fax: 772-466-6248
E-Mail: Phone No. 772-465-3232
Fill in fee simple Title Holder on next page(if different E-Mail:.Sisdevinc@aol.com
from the Owner listed above) State or County License: CGC1505059
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x 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.
C� s
_Signature o Owner Lessee/Agent Signature of ontractor Licens Holde
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF saint Lucie COUNTY OF Saint L-ie
The forgoing instrument was acknowledged before me The forgqing instrument was acknowledged before me
thisP day of�' _rG k-1 20 I ZOby this day of -rG'`1 ,20 �bby
(Name of person acknowledging) (Name of erson acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notaryublic-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced ,,, o dentification Produced
,� $ aSa `` _ Commission#EE 52252
Commission No. { Expires Novembe 1i, ion No. •:i:: K/� �FEIN
'411 ,5�,' Bor"7lwTmyi�nins= ea �� =,`; = Commission#EE 852252
Expires November 18,2016
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS