HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED II��
Date: Permit Number:3111111
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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 X
PERMIT APPLICATION FOR: Concrete
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PROPOSED IMPROVEMENT LOCATION:
Address: 110 NE Naranja Ave Port Saint Lucie FL 34983
Legal Description: RIVER PARK-UNIT 4 BLK 40 LOT 23 (MAP 34/28N) (OR 3175-875)
Property Tax ID#: 3419-530-0245-000-2 Lot No.23
Site Plan Name: Block No. 40
Project Name:
Setbacks Front25 Back: 15 Right Side: 10 Left Side: 10
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DETAILEDDESCRIPTION-OF WORK: '
REPLACE EXISTING CRACKED DRIVEWAY & ADD TURN AROUND AREA
CONSTRUCTION,-INFORMATION:
Additional work toe e orme under this permit—c ec a appy:
HVAC Ei Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 1500 S . Ft.of First Floor:
Cost of Construction:$ 2300.00 UtiIities: Sewer 11 Septic Building Height:
OWNER/LESSEE:- CONTRACTOR
Name ROBERT P DUDLEY Name: H.O.B.
Address:110 NE NARANJA AVE Company:
City: PORT SAINT LUCIE State:FL Address:
Zip Code: 34983 Fax: City: State:
Phone No. Zip Code: Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION; LIEN LAW IN.F,ORMATION;
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: I x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone: I
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FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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 o . A Notice of Commencement must be recorded and posted on the jobsite
before the f' ion. If you tend to obtain financing, consult with lender or an attorney before
commenci o or recordin our Notice of Commencement.
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_Signatureof 0 ner/ see/Agent Signature of Contractor/License Holder
STATE OF FL I A STATE OF FLORIDA
COUNTYCOUNTY OF
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The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of (Y'kQ,,, 20(f(Lby this day of20 by
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(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Publi State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
F>_. Identification
o.-nss• i o9L.•0 _
Commission No. S I Commission No. il (Seal)
'2O%-p3ty P&Zo,, LASHAHNA INGRAM
=' •=My Comm.Expires Dec 2;:,2'0'"148
Revised 07/. Commission #FF 177249
Bonded through National Notar
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW I REVIEW REVIEW
DATE
COMPLETE
INITIALS
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