HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l.] /� �
Date: Permit Number: I(DO( Q�
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division I
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION: i-WIN IONIC
Address: 3110 S.23rd St
Legal Description: COL H D GOFORTH S/D BLK 1 LOT 21
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Property Tax ID#: 2428-602-0021-000-1 ! Lot No.21
Site Plan Name: Block No. 1
Project Name: j
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Setbacks Front Back: Right Side: Left Side:
DETAILED DE$CR'IPTIOUO'F'WORK: "
XcS�4,0� A00szJ^-J AN a( "AjcV e( I/k'-( m s-f 4a l I Tt3 o Pp_
CONSTRUCTION_INFORMATION. A Of
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Additionalworkto a er orme under this permit—check a t t appy: j
HVAC Gas Tank ❑Gas Piping Shutters O Windows/Doors
Electric Plumbing OSprinklers Generator I Roof 3.12 Roof pitch
Total Sq. Ft of Construction: 1400 Sq. Ft.of First Floor:
Cost of Construction:$ 4500 Utilities: Sewer Septic Building Height:
°.OWNER/LESSEE: CONTRACTOR: r1
Name SCOTT LOCKE Name: RICHARD COLLETTI j
Address:3110 S 23RD ST Company: LEAK BUSTERS ROOF REPAIR LLC
City: FORT PIERCE State:FL Address: 6101 BUCHANON DR
Zip Code: 34982 Fax: City: FORT PIERCE i
J State:FL
Phone No.407-620-7347 Zip Code: 34982 Fax:
E-Mail: Phone No. 772-801-8393
Fill in fee simple Title Holder on next page(if different E-Mail: JESSEBREWER422@GMAIL.COM
from the Owner listed above) State or County License: CCC1330976
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SURPLEMENTALCONSTRUCTION LIEN LAW INFORMATION: I-
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DESIGNERJENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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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 thepermit 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 fender or an attorney before
commencing work or recording your Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contract r/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -'Sk- LL'C-�Ip— COUNTY OF � I—Lc'-Q_
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Thef(Today
instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ( day of SepA- 20 -�(oby this day of S.O-per_20 R, by
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(Name of person acknowledging) (Name of person acknowledging)
(Signature qf3llotary Public-St e bf Florida) (Signature o otary Public-Sta e f Florida)
Personally Known K OR Produced Identification Personally Known OR Produced Identification X
Type of Identification Produced Type of Identification Produced
Commission No. l►"7"�$ea CASEY BINK WUnirmsion No. -(SeaQCASEY BINKLE
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MY COMMISSION 4 F238333 MY COMMISSION4 FF2 33EXPIRES August 16,.201 B URLI;e
Revised 07/15/2014 140h3WOo.0' VlbfldhN„1a. @arvkarMT. i40/19!liG1”: FltrtWnNn(erySarvre:rvr.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS i