HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/9811ti Permit Number:
a
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 Residential it
PERMIT APPLICATION FOR:
PRO(�QSED INPROEMtNTLOCATION .s
Address: 7601 Donlon Road
Legal Description: Lots 24 and 25 (MAP 13/11N) (or 403-2846)
Property Tax ID#: 1301-605-0095-0016 Lot No. 24
Site Plan Name: Block No. 4'3
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION tJF WORK ,
hCA
GQNSTRUCTION INFOR111CATON
Additionalwork to be performed under this permit–c ec a I that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
X__Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ $1 nnn nn Utilities: —sewer _Septic Building Height:
OWNER/LESSEEx CCINTRACI'OR
Name Robert J- S�ti hg Name:
Address: 7601 Donlon Road Company:
City: Fort Pierce State:FL Address:
Zip Code: 34951=1771 Fax: City: State:
Phone No. 772-1,19-1 59A Zip Code:
E-Mail: rspring@irsc:edu Phone No
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County Lic se
If value of construction is 2500 or more,a RECORDED Notice of Commencement isy6quired.
SUPPLEIIJIENTAI_CONSTRUCTION UEN LAW tIVFQRMATI(3N
DESIGNER ENGINEER:
/ Not Applicable— pp MORTGAGE 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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 thest inspe ion. If you intend to obtain financing, consult with lender or an attorney before
commenci w rk o cording our Notice of Commencement.
1A1 '
i
Signature o O ner/ ss /Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF ORIDA STATE OF FLORIDA
COUNTY OF �` ''�� �,�,�� COUNTY OF
Theing i stru t was cknowledg d efore me The forgoing instrument was acknowledged before me
this a f 204,0 by this day of 20_ by
(Name of person acknowledging) i (Name of person acknowledging)
.j
( ' ature of Nodry Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification ,, Personally Known OR Produced Identification
Type of Identi ' Type of Identification
Produced ` "�� GELD_,,_
Produced
da' ° CommissioCommission No. (Seal)
Commission N'. •• mmExp19°PBonded through ssn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Te—v. 712014