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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: —so'ZmI& Permit Number: AN-7 03 m r. � RECE .m 7773 Building Permit Application 4 Planning and Development Services JUL °0 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial XXX Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEM'ENT3LOCATICN _ _.. , _ .... v.. Address: 5500 Saint Lucie Blvd. Fort Pierce, Florida 34946 Legal Description: 30 34S 40E 30 34 40 Beg at SE Cor SW 1/4 of SW 1/4 Run W on S Ii of SD SW 1/4 of SW 1/4 333 Feet,Th N to PT on Li of SW 1/4 of SW 1/4 331.2 feet W of NE Cor of SW 1/4 Continued on Tax Roll Property Tax ID#: 1430-331-0001-000/8 Lot No. Site Plan Name: Road Runner Travel Resort Block No. Project Name: Setbacks Front�j� 1 Back: 51 Right Side: l�, Left Side: l o `DETAILED DESCRIPTION OF WORK � � g� '� Install�Jfoot X 8'foot Shed DCA 1I� © `� ��fir� 'C' RU INFORMATION b. ..�. . .. _ e Additionalwork to be nertormed under this permit—check all appy: HVAC Gas Tank Gas Piping _Shutters E]Windows/Doors 11 Electric 0 Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: �T • S . Ft.of First Floor: Cost of Construction:$ �i� . 00 Utilities:n Sewer E]Septic Building Height: OVI/N�RJLESSEE ` { h CONTRACTOR ....s._o ..,, a .. Name Marilyn Minix Name: Lori Williams Address: 5500 Saint Lucie Blvd. Company: D & M Concrete Constuction Inc. City: Fort Pierce State: F1 Address: 331 Sunrise Dr. Zip Code: 34946 Fax: (772)464-0987 City: Fort Pierce State: FL Phone No. (772)464-0969 Zip Code: 34945 Fax: E-Mail: sean@roadrunnertravelresort.com Phone No. (772)465-4355 Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: #24764 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _Not ApplicableMORTGAGE 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 ipstallation 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. �^ W `A"v ` •.dam s _ Signathre of Own /Less gen f�ignature oGonttor�License Holder STATE OF FLORIDA STATE OF FLORID COUNTY OF ST• utc 1�_r COUNTY OF "• The forgoing instrument was acknowledged before me The forgoing in ment was acknowledged be III fg this f ay of S(L L'q 20 Lby. this L_day of 20/f'! 4:2 "o M�� m��i��/J M/P 4-0 rz� lots; s• (Name of person acknowledging) (Name of person acknowledging) NT i_ a&xm (Signat a of Notary Public-State of Florida) (Signature of N ry Public-Sta a of Florid ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. r-FA318/v (Seal) Commission No. (Seal) �' CYNTHIA BAKER Revised 07/15/201 MY coMNIIss1oN#FF231810 EXPIRES:June 29,2019 1 OF REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS