HomeMy WebLinkAboutBlocking Diagrams ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: kaCef • DW
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 i Residential X
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PERMIT APPLICATION FOR: Other
PROPOSED.IMPROVEMENTS LOCATION:`
Address: 12585 S Indian River Dr, Jensen Beach, FL 34957
Legal Description: 4 37 41 FROM SW COR LOT6 BLK 2 SPRING HILL S/D RUNS 28 DEG 30 MINE ALG PROJECMN ELY LIST 176.37 Fr TO POB,T H
CONT S 28 DEG 30 MINE 120 FT,TH N 61 DEG 30 MIN#437.7 FT TOW SHORE RIV,TH NYWLY ON RIV 120 Fr,TH SWLY 451 a FT TO POB(7)OR 3888-903;3893-2109
Property Tax ID#: 4504-310-0003-000-2 Lot No.
Site Plan Name: Block No.
Project Name: Lounsbury Door
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
d oo-- 16'x q �
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CONSTRUCTION.INFORMATION.
Additionalworkto e e orme under. this permit—cneEF-all that appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing ❑Sprinklers l- Generator j D Roof Roof pitch
Total Sq. Ft of Construction: S .Ft.of First Floorl
Cost of Construction:$ j,--' q q Utilities: Sewer Septic Building Height:
OWNER/LESSEE:, CONTRACTORA
Name 12,Lh oy1J /t7✓,-<AName: Terrance D;eVault
Address: 1 Z C-M Company: Customer's Choice Garage Doors&Openers,Inc.
City: _c,c� /3e,c_I^ State:�Z Address: 706 NW Buck Hendry Way
Zip Code: Fax: City: Stuart I State:FL
Phone No. Zip Code: 34994 Fax:
E-Mail: Phone No. 772-675-1066
Fill in fee simple Title Holder on next page(if different E-Mail: driettC live�com
from the Owner listed above) State or County Li cense: 29223 SLC
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPP.LEMENTAL,CONSTRUCTION LIEN LAW INFORMATION': .
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: i Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
1.
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name: _
Address: Address:
City: City:
Zip: Phone: Zip: Rhone.
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 ny 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 Mender or an attorney before
commencing work or
recording our Notice of Commencement.
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Signage of Owner ssee/Contractor as Agent for Owner Signato-re oT-Contractor/Liceridd Holder
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF airy- fig COUNTY OF I1 �►z
The forgoing instrume t was acknowledgeo before me The forgoing instrument was acknowledged before me
this Ile day offWJnM20by this day of 20 by
(Name of person acknowledging) (Name of p rson acknowledging)
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(R gnature of Notary P blic-State of Florida) ( ' nature of Notary Public-State of Florida)
Personally Known OR PrgduGf-d Idec�tiffCat�,n Personally Known I OR ProdgRo identification
Type of Identification Produce V:�p lla. rffPne Type of Identification Produced t�:�!! David TFm one
=a ommisslon _-A Commission#FF164909
r lea •�' res:OCT 01,2018 Commission No. 'z'X es:OCT Ol,2018
Commission No. F I�qq - y T-F �
➢ONDED THRU •,,�a BONDED THRU
'�'•. , •��
IST FLORIDA NOTARY,LLC '•nu,�����• 1ST FLORIDA NOTARY,LLC
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE L
COMPLETE
INITIALS
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