HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/5/16 Permit Number:
t
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 X Residential
PERMIT APPLICATION FOR: Window/door t
P:ROPQSE.D_IMPROVEMENT LC►GATION s
Address: 5050 South 25th St.
Legal Description: White CityS/D 04 36 40 S 150 FT W 355 FT OF W 1/20F-- (map 34/04S) (or 1702-802478-1497)
Property Tax ID#: 3403-502-0096-010-9 Lot No.62
Site Plan Name: Cheyne Professional Complex Block No.
Project Name: Cheyne Professional Complex Rear Doors
Setbacks Front Back: Right Side: Left Side:
DETAILED'DESCRIPTION OF WORK
Remove and replace South side rear doors (3)
s, f �orwo
COIVSTRUGTI O.N INFORIVIQTION
Additional work toe e Orme under this permit—check k a appy:
HVAC In
11 Gas Tank E]Gas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 2,100.50 Utilities:n Sewer o Septic Building Height:
OWNER/LESSE'E p r
CON
Nam ey n arl Gaines
Address:5050 S 25th St. Company: E & B Elite Services
City: Ft. Pierce State:FL. Address: 5821 Starcher Ave
Zip Code: 34981 Fax: City: Ft. Pierce State:FL.
Phone No.(772)201-6885 Zip Code: 34947 Fax: (772)465-2351
E-Mail: Phone No. (772)577-0826
Fill in fee simple Title Holder on next page(if different E-Mail: ERLGAINES@COMCAST.NET
from the Owner listed above) State or County License: CGC1517445
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SURPLEIVIENTAL CONSTRUCTION LIEN Lg1N INFORMATION mE '
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.
Ac=,_ t s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA r STATE OF FLORIDA ' ` °
COUNTY OF COUNTY OF Y� �o/L(',l `ems
The f rgoing instru. ent a n wledged before me The f rgoing instr nt was acknowledged before me
this day of 20by this day of=4 . 20 by
1
(Name of perso acknowledging) (Name of person ac n wledging)
(Signature of Notary Public-State of Florida) (Si na Notary Public-State of Florida )
erson OR Produced Identification Personal! , *�RYo•• O Ari
o ion Pro ype o p A M HUFF
;�° I �.� 'o* * '° Co -orate of Florid
Notary Public-State of F '�F `oP�P,,My Commission #FF 2347 a
Comm � Co hfl) Commiss.jori'I+�`d,� �'° mm.E @lea
FF 2347730 a througbNationNo27 2019
,O '�P,, on edmm.Expires May 27,2019 - �yAssn.
thrm
ary Assn.
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS