HomeMy WebLinkAboutBuilding Permit Application • '9LL,APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED .�1� /
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Date: 8129117 Permit Number: LJ CL
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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 X
PERMIT APPLICATION FOR: Demolition
PROPOSED IMPROVEMENT LOCATION:
Address: 12774 NW Mariner Court, Palm City, FI 34990
Legal Description: Harbour Ridge Plat 4 Tract D or 715-241:2447-1629:2586-693:3449-6 thru 12:3458-2599:3458-2602:3458-2605
Property Tax ID#: 4425-603-0011-000-8 Lot No.
Site Plan.Name: McCoy Demo Block No.
Project Name: McCoy Demo
Setbacks Front Back: Right Sider Left Side:
DtfAILfD DESCRIPTION OF WORK: 4
Complete Demo of Residential Home
CO'NSTRUCTIOWNFORMATION:
Additional work to fi
orme un er t is permit—c ec a appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric O Plumbing Sprinklers E]Generator Roof ' Roof pitch
Total Sq. Ft of Construction: 3/ 2a) 'J S . Ft.of First Floor:
Cost of Construction:$ � I .r Utilities: Sewer Septic Building Height:
0NER/LESSEE: CONTRACTOR:
Name William H McCoy Name: Steve Rubin
Address:1571 Sweetbay Circle Company: Rubin Custom Homes
City: Palm City State:FL Address: 4253 SW High Meadows Ave
Zip Code: 34990 Fax: City: Palm City State:FL
Phone No.610-733-05261772-336-1492 Zip Code: 34990 Fax:
E-Mail:macmccoyii@yahoo.com Phone No. 772-283-0553
Fill in fee simple Title Holder on next page(if different E-Mail: reception l.rubincustomhomes@gmail.com
from the Owner listed above) State or County License: CGC1518190
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTIO -LIEN LAW INFORMATION; '
i
' DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ of Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: of 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 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 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
lyllllx�1;41s
ignature of Owner/Lesse /Contractor as Agent for Owner 'Signature of Contractor/License Rblder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF IA.Gt COUNTY OFrZ:C LAA C _
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 05_day of 9 20 U—by this day of ,20 �q by
(Name of person acknowled ' ) (Namerson acknowled�ing)
(Signature of Notary Publi - tate of Florida) (Signature of Notary Pub ic-Sta, of Florida)
Personally Known v"' OR Produced Identification Personally Known OR Produced Identification
Type of Identification Pr Type of Identificati Arca
Commission No. �' •�•' `' SyFRR/( Commission No. :. Co ER._ LE Sea
°Com . FF999
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Revised 07/15/2014 r�yFa1n180`�110.3 YF�nlnsu� BO�B�7019
87019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS