HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1-22 0-2A le Permit Number:
RECEIVED
Yen
Building Permit Application JAN 11 2017
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: Shed DCA E '
E�
�PROPOSEDIIVI R�®VEMENT,��CAT�IQN: `�
Address: 5500 Saint Lucie Blvd. Lpt#�—
Legal Description: 30 34S 40E 30 34 40 SW 1/4 OF SW 1/4 LESS A STRIP OF LAND ON E BEING 331.2 FT ON N LI
.&333 FT ON S LI (OR 322-2003)
Property Tax ID#: 1430-331-0002-000/5 Lot No.
Site Plan Name: Road Runner 1(Lpk)t-L Block No.
Project Name:
Setbacks Front ,5 Back: g. Right Side: I�1 l_Left Side: _
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DETAILED DESCRIPTION DF WORK M p,a R,x
'c .r. ?-� ��' Illu w 4�
Install$foot X 8 foot shed DCAJ-L _ NC-1 r(pk /),g be
Mli
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CQ STRl1G�T10N INFORIUTA4TLON
.5� �' ��RrRY.'M9L.ml�Q'�r'4��rTn'aS.}iY'-rY.;!X•14. 1. .'e.ill..:.. -..a ':: 4'r v,. :i:k I, -M. _r :».:. .._ I, ..:::. r�'i
Additional work to bfIrformed under this permit-check all appy:
aHVAC Gas Tank E]Gas Piping _Shutters El Windows/Doors
Electric ❑_Plumbing F ]Sprinklers Generator a Roof
Total Sq. Ft of Construction: (J-l �� Sq. Ft. of First Floor:
Cost of Construction:$ 7i, 000 , 00 Utilities:Sewer O Septic Building Height: I
n§_
OWNER/LESSEE k CONTR ►CTOR .,,
.�
Name Marilyn Minix.,',,:'... Name: (_
Address 5500`S6int Luce'E§Ivd. . any:
City: Fort Pierce. _....,Y,.
FI.
State: Address:
Zip Code:34946, Fax.?7z 464-0987 City: -- Stater
Phone No.772-464-0969 Zip Code: a?�9YS Fax: y6 r e6;,'7
E-Mail:sean@roadrunnertraveiresort.com Phone No. -ge( -7
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
S',UPPLEMENTAL CONSTRUCTI'N Lf'EN�LAW�LN':F®RMATI®N`
DESIGNER/ENGINEER: _Not Applicable 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:
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.lender or an attorney before
commencing work or recording our Notice of Commencement.
s
_
Signature of Owne /Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA ' ILL STATE OF FLORIDA ,i
COUNTY OF COUNTY OF fit-'
The fo oing instrumen s acknowledge before me The forgoing instrument was acknowledged before me
this day of t lf�tlgoe, 20it Le7by this L day of -T41-,u C,y-L. 20 �,by
1 �o IN I ll pt M S
(Name of person acknowledging) (Name of person acknowledging)
bim O<�QJ�- 0a-42
(Signat a of Notary Public-State of Florida) (Signature of gotary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 3/81d �� C(' 'b)'HIABAKER Commission No-�• .0 KARYW&PRAWDY
d A1Y COMMISSION#FF231810 =•; �•5 MY COMMISSION#FF198658
EXPIRES:June 29,2019
ExPIRESEeb-alyll 9019
14C��'+96.0153 florfdallou 3Mvko,con+
Revised 07/15/2014 ---
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS