HomeMy WebLinkAboutBuilding Permit Application J
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ALL APPLICABLE INFO MUST BE COMPLETED-FOR APPLICATION TO BE ACCEPTED (�
Date: Permit Number: ho I ��t1
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Building Permit Application
Planning and Development Services PERMITTH GSt.Lucie County. !_1_
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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PROPOSED IMPR011EMENT L F CATIflN
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Address: 5857 Sunberry Cir.
Legal Description: Portofino Shores(13643-6)Lot 466 (OR 2741-1767; 3985-2245)
Property Tax ID#: 1312-501-0125-000-1 Lot No.466
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right.Side: Left Side:
DE�AItED^DESCRIPTIO,NiOF WORK
replace 1 door size for size
'CC3NSTRl1CTIN INFORMATION ,
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Additional work toe nertormed un e r th is permit—check a 11 appy:
11HVAC Gas Tank FGas Piping _Shutters Q Windows/Doors
Electric Plumbing 1:1Sprinklers ElGenerator E] Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 5687.00 Utilities:i Sewer Septic Building Height:
0111 N ER/LESSEE '9 CONTRACTOR
Name Grace Chin-Marcos Name: Raquel Swanner
Address:5857 Sunberry Cir. Company: The Home Depot
City: Fort Pierce State:FL Address: 6500 NW 12TH Ave. Suite 110
Zip Code: 34951 Fax: City: Fort Lauderdale State:FL
Phone No. � GAO '7� Zip Code: 33309 Fax:
E-Mail: Phone No. (754)224-2010
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CGC1514813
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
4S 134P, CONSTRl1CTlON LIEN LAWINFORMATIdN
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:
1 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 Com t must be recorded and posted on the jobsite
before the first inspection. If you intend to o In financing, c sult with lender or an attorney before
me c work or r o our Notic of Commencemen
Signat 0 /L ssee ignat a of Con actor/License Holder
STA F FLORIDA STATE OF FLORIDA
COUNTY OF t d COUNTY OF Ly411�
The forgoing instrument was acknowledged before The forgoing instrument was acknowledged before me
me this 1?�L day of Ju-Y 20 17 by this-%-6 day of _XXX 20_17 by
lax�nac
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced pe of Identification Produced
"va"• TIMOTHY R.O'MALLEY
Commission No. :',S�" � �.�>�YPY• MOTHYR.O'MALLEY
}: N(��jl(�MI$SION#GG 117135 mmission No. go �•.�(SealRES'August 7,2021 .,AN. MY OMMISSION#GG1171GIiC UndefwriteEXPIRES:August 7,2021
•nua•` Sonow I nru 1ry IC 0
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS ,
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