HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/25/2016 Permit Number:
•
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: Plumbing p-
PROPOSED IMPROVEMENT LOCATION:
Address: 5501 Orange Ave
Legal Description: 73540 mr 1/4 of=l/4415 40ft rd endless a40 Read leu as N CA#82-131-05 and less a 641.850and less E230 FT of W270 FT OF N 19026ft of s.27028 ftof my 1/4o1sw 1/44ass s 54185ft-(20.48 ac)(u 1353-2878.2678)
Property Tax ID#: 2407-321-0001-000-8 Lot No.
Site Plan Name: 5501 orange ave Block No.
Project Name: 5501 orange ave
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION'OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be nertormed under t ispermit—check all
appy:
HVAC Gas Tank E]GasPiping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers 1:1 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: 500 S . Ft.of First Floor: 7904
Cost of Construction:$ 2000 Utilities: Sewer Septic Building Height: 20
OWNER/LESSEE: CONTRACTOR:
Name Miller properties Name: Scott Cross
Address:5500 orange ave Company: All contractor sys- Rooter One
City: Fort Pierce State:Fl Address: 4814 s. us hwy 1
Zip Code: 34947 Fax:7725959191 City: Fort Pierce State:FI
Phone No.772-812-1771 Zip Code: 34981 Fax:
E-Mail: Phone No. 772-812-1771
Fill in fee simple Title Holder on next page(if different E-Mail: scott@rooterone.com
from the Owner listed above) State or County License: CFC1428754
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL,CONSTRUCTIO.N 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, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
lC�_ s
i nature of Owner L ssee/Contractor as Agent for Owner a ure of Contractor/L' ase Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STluafeCounty COUNTY OF St Lucie
The forgoing instrum nt was acknowledged before me The forgoing instrument was acknowledged before me
this ZS day of c.LS't 20 t Eby this qday of 25 i 20 by
o I I10 s � 101- CCO 1l� ns
(Name of erson acknowledgi g) (Name of son acknowledging)
(r
!r 1S
(Signa ure of Notary Public-State of Florida) (Signat re of Notary Public-State of Florida)
Personally Known �//--9R-P�c�aspd ldcntificat��� Personally KnowrYificatoon
Type of IdentificatiorE Rid �1 LINDA C COLLINSType of Identificatio P[o d
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My COMMISSION 0 FF192590 I:': ;'_ My COMMISSION 0 FF192590
Commission No. s':b . 1c�'�i�
Commission No. '� ExPIRE(§ t 09.2019 —EXPIRES W96.2019
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW, REVIEW
DATE
COMPLETE
INITIALS