HomeMy WebLinkAboutBuilding Permit Application II
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/8/2017 Permit Number: i
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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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 7708 CITRUS PARK BLVD II
Legal Description. LAKEWOOD PARK/UNIT7-BLK75 LOT13(MAP 13/02N )(OR 1284-139sl5)
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Property Tax ID#: 1301-607-0144-000-1 Lot No.
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Site Plan Name: Block No.
GUALDA RESIDENCE
Project Name: 1
Setbacks Front Back: Right Side: Left Side: 1
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DETAILED DESCRIPTION OF WORK:
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Repale existing meter can damaged during hurricane Erima
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CONSTRUCTION INFORMATION:
Additional workto e performed under this permit—check a appy: II
HVAC E]Gas Tank Gas Piping _Shutters II Windows/Doors
Electric ❑Plumbing []Sprinklers ❑Generator Ed Roof Rooflpitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor: i
Cost of Construction:$ 850.00 Utilities: _Sewer E:]Septic iBuilding Height:
OWNER/LESSEE: CONTRACTOR:
Name Juan Gualda Name: John Malanczyn j
Address:7708 Citrus Park Blvd Company: Malanczyn Electric, Inc.
City: Ft Pierce State:FI Address: 1535 S Niemeyer Circle
Zip Code: 34951 Fax: City: PSL i� State:FL
Phone No.772-979-5656 Zip Code: 34952 Fax: 772-335-4034
E-Mail: Phone No. 772-263.9129 1I
Fill in fee simple Title Holder on next page(if different E-Mail: jmalanczyn@aol.corp
from the Owner listed above) State or County License: EC-0001492
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: n ;I
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: jj _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: j _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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. 11
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,
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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 ori an attorney before
commencing work or recording our Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/Licensd Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF II
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The fei�going instruwa c<nowled efore me The&rgoing instr nt w acknowledged before me
this�day of 2i by this day of !� 20_ by
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n ma ing statement a son making statement
Personally Known OR Produced Identific ion Personally Known OR Produced Identification
Type of Identific
ProducedA Produced li
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( ignat e i ul ic-State of Florida) (Signature ofN tL 3liar� faElciri+a.
PaV P��� ANGELA M HUFF
ANGELA M HUFF a c
CU tnis .0NotaryP„ � (S al) Commission c}i' Notary Public SQ5�a1t)rlorida
State of Florid' E.
*•` Commission# FF 234730
Commission#
nay Con FF 234 73 0 ,F o�°� MyiComm.Expires May 27,2019
m.Expires (. 7,,OF F�•J�
REVIEWS FRONT ZONING' SUPERVISOR PLANS VEGETATION ISEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE I '
COMPLETED
Rev.8/2/17
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