HomeMy WebLinkAboutBuilding Permit Application From:
1 386 427 8911 08/0212016 14:50 #490 P.0021004
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t
Date: 6127/2016 Permit Number: " V
"se'+t;is RECEIVED ,
Building Permit Application AUG 0 2 2016
Planning and Development Services
ING
Building and Code Regulation Division Lucie1tT unty,
2300 Virginia Avenue,Fort Pierce Ft 34982 St. Lucie Gaunty, FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION.FOR: Demolition 177-11
PRPOSEQ:.1 �}��'QVI=,HIEN L�O�CA1,IQN
Address: 4'0m
Legal Description: 34 -� S E I�4 D ' N ;r5�'"GESS' /1//D(a F L� b o'F E #ski
CberoW,. by Exkrtdodt ,9)-u: &Mid r'IL cS E !yU 11-7'-> F72M a ,
PropertyTax'lD 1 (.Q.- �— � Lot No.
Site Pian Name: Block No.
Project Name-
Setbacks . Front Back: Right Side: LeftSide:
C'�t%s Room afxd NKDA
Additional work o m6asTank
orme un er sperm —c ec a app y:
[J. ❑Gas Piping _Shutters Windows/Doors
0Electric nPlumbing ❑Sprinklers FIGenerator Roof
Total SQ.Ft of Construction: 1 SQ'.Ft,;* of First Floor.
Cost of Construction:$ Utilities:[]Sewer 0 Septic Building Height:
Name &D AFFILIATES INC Name:MIKE BiCKERSTAFF .
"Address.314 S.ERIE DRIVE Company:AMERITECH HOMES INC
City: FT PIERCE State:FL Address: 265 S STATE RD 415
Zip Code:34946 Fax: City: NEW SMYRNA BEACH 5tate•FL
Phone No.772.461-1211 Zip Code: 32165 Fax:386-427-8911
E-Mail Phone No. 386-427-7899.
Fitt In fee simple Title Holder on next page(If different E-Mail:PERMITS@AMERITECHHOMES.COM
from the owner listed above) State or County License:IH1025202
if value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
From: 1 386 427 8911 08/03/2016 14:51 #490 P.003/004
rte.isaort+7�-l��cx: #z••taa:.tt `$ rK '�'S'w '^j'b' +. 1ka 4'+l'a yi
S. d R atra .°,Ss,� wti`�•3+n�rs,5',S' t fi5 .. fir=
SUPPLEMENTALCONSTRUtTlON LIEN LAW�It+�FORMATIONxa� 3 N &�
:, :7�}'"xa�S'�;K .2u�,: 0E3T%,-...f$Ux t`. erg,• �' m.. k't EN. r ata e h'�e t�'i�'ydtr�.Hca (.c!.ar:.:u,$v ''3.ar.Y•mdA«''-t dL "tr1:� �9t:'" «s+ `' �yts� .
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable x
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 di 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
iii accordance iniith the approved plans;the Florida Building Codes and St.Lucie=CountyAmeodments.
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.
S .
17
_Signature of Owner/Lessee/ nt Signature of Contractor/Licen
STATE OF FLORIDA STATE OF FLOIp
COUNTY OF_ VMI A�j Ck. COUNTY OF 1� US I
The fo ling Instrument was acknowledged 1[b�efo.re me The forgging Instrument was acknowledged before me
this day of s�' 20�by this day of 20 _L(p by
AW &_Ua4aW
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-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 oduced
Commission No. w A N.MILLWATER Commission No. F�4�aal (Seal
s�= ; f Notary Public,State of Florid gRIANNA N.M1WATER
* °+` Jan.10 202Notarypublic,state of Florida
My Com
'+ .i m Expires an.
9 Commission No. FF 949221 iN:
10,2n9n
Revised 07/15/2014s� •._„ Commission No.FF 949221
OF'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS