HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
6/20/2016
Date: Permit Number: �
Wells
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: SidingEl
PROPOSED IMPROVEMENT LOCATION:
Address: 6405 Doris Drive Fort Pierce, Florida 34951
Legal Description: Lakewood Park-Unit 8-B- Blk 3 Lot 12(Map 13/02N) (OR 3812-703)
Property Tax ID#: 1301-610-0040-000-2 Lot No.12
Site Plan Name: Block No. 3
Project Name: Renovation
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove existing siding and replace with T-1-11.
CONSTRUCTION INFORMATION:
Additional work toe performed under this permit—check a appy:
HVAC 13 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers 1:1 Generator F� Roof
Total Sq. Ft of Construction: 400 s/f S . Ft.of First Floor: 1640
Cost of Construction:$ 2,000.00 Utilities Sewer Septic Building Height: 15
OWNER/LESSEE: CONTRACTOR:
Name Midlands Developement LLC Name: Larry McDona)d
Address:7741 North Military Trail-Ste. 1 Company: Southeast General Contractors Group, Inc.
City: West Palm Beach State:FL Address: 20423 SR 7-Ste. F6-418
Zip Code: 33410 Fax: City: Boca Raton State:FL .
Phone No.(561)885-2037 Zip Code: 33498 Fax: (877)756-0007
E-Mail: Phone No. (877)407-3535
Fill in fee simple Title Holder on next page(if different E-Mail: Lmcdonald@southeastcontracting.com
from the Owner listed above) StateC t n e• CGC060247
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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, cons It with lender or an attorney before
commencing work or recording our Notice of Commencement.
s
Signature 6f6wner/4is'ee/Agent� Signature of ntractor/License Holder
STATE OF FLORIDA STATE OF FLOR
COUNTY OF l� n..c�i'-1 COUNTY OF T&COUNTY &OCYN
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this��`day of ; i 20 Eby this L day of .20 (0 by
.�r, � cairnek
(Name of person acknowledging) `,``.. )Gt�l MMllMlSlllS
y% (Name rM C ledging)
*t• FF�MBfR Oti t�
�` Z: EX Af88
(S-igriatafe of ry Public-State of Fri ,y°::arc (Signature of Notary Public-State of Florida)
Personally Known X OR Produced 500 Personally Known ',v4- OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. -F',7c)\\S� (Seal) Commission No. 2
• NICOLLETrE BENICHI6
MY COMMISSION 0 FF112219
OPF
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS