HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 519116 Permit Number: 5 -o V50
RECEIVED MAY 0 9 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 Residential XX
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line W q
PROPOS ED]MPROVE MENT LOCATION
Address: 3201 Ixonwood PSL 34952
Legal Description: Savanna Ctub Hat two btk 20 tot 4
Property Tax ID#: 3425-702-0198-000-3 Lot No. 4
Site Plan Name: Block No. 20
Project Name: tri cl wJa�1/
Setbacks Front r Back: 60'' Right Side: Left Side:
DETAILED DESCRIPTION OF WORK_'
Extend d&iveway 6 ' &ight ent4ance
4" thick 3000PSI with U i,ben meth
CONSTRUCTION,INFORMATION.
Additional work to be nertormed under this permit—check all t appy:
HVAC Gas Tank ❑Gas Piping Shutters ❑Windows/Doors
Electric 0 Plumbing []Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ Utilities:Sewer Septic Building Height:
O-.WNERKESSEE: CONTRACTOR:
Name Roben-t 8 "Nance" King Name: Jose V.idez
Address: 3201 Inonwood Company: JozB Concne#e Penbection
City: P S I State: F I . Address: 383 S W N o t th S h o A e
Zip Code: 34952 Fax: NA City: PSL State:--F L
Phone No. 336 9965 Zip Code: 34986 Fax: 343-0764
E-Mail: NA Phone No. 772 8 1 2 5066
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: 25230
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
S JPPL--EMENTAL CONSTRUCTI;ON'LIEN.LAW INFORMATION ,
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 w k or recording our Notice of Commencement.
s
_Signature of ner essee/Agent Signature of on o er
STATE OF FLORIDA STATE OF FLOEUDA
COUNTY OF A V, LU c. -R COUNTY OF SSS-; Ly
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this CN day of VA,q 20 Eby this day of 20 ��o by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary PubVic-State'of Florida) (Signature of Notary P lic-State of Florida)
" � PG\ °tF�02��5 Personal) Known OR Produced d 'd�t�\VENStF�O"da `
Personally Known OR P�o ce ifg1�'t�o�n`6. y �1t�fy SQ����6 .
Type of Identification Produced"" est° g16 Type of Identification Produced
`� �rti�:- �„,,,.., No�a�y ExP`� #9E8 sn•
Commission No. �b�J/ �`y G �'G hNa"°na\ Commission No. c My t� ml�sion a�No�aty Ps
�hco^ ° mss
Revised 07/15/2014 '
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
COMPLETE
INITIALS