HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO 1MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater , L 1 Permit Number:
Building Permit Application DEC 12 20117
Planning and Development Services PER'UlWINNG
Building and Code Regulation Division St. Lurie County, FL
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
PROPOSED IMPROVEMENT LOCATION:
Address: 5620 Spanish River Rd.
Legal Description: Portofino Shores-Phase Three-(PB 43-40) Lot 245
Property Tax ID#: 1312-503-0051-000-7 Lot No.245
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
replace 1 door size for size
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
HVAC 11 Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator F] Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 5523.00 Utilities:n Sewer 1:1 Septic Building Height:
OWNER/LESSEE: CONTRACTOR.
Name Joseph Noel Name: Raquel Swanner
Address:5620 Spanish River Rd. Company: The Home Depot
City: Ft Pierce State:FL Address: 6500 NW 12TH Ave. Suite 110
Zip Code: 34951 Fax: City: Fort Lauderdale State:FL
Phone No. 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.
[SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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
befor first inspection. If you intend to obtain financing, c It with lender or arNttorney before
c,oi-nmencirlig work or re r o tice of Commen ent.
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Signature wne see Signature/dfContra for/License Holder
STAT F FLORIDA STATE OF FLORIDA
CO TY OF COUNTY OF
The forgoing instrument was acknowledged before The fq_rgoing instrun),ent was acknowledged before me
me this 4 day of [),I C. 20 17 by this day of y-e-c- , 20_17 by
1L 'Aq V*'l SWAil't.1 g4x1L,&.,e,l JGJ 14'111 l__
(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 Type of Identification Produced
Commission No. emission No. (Seal)
VeT1tfC=VM1si4a0f ?:1:. Y
�1h:':lt•; 71MOTHY R.O'MALL Y �•°".'P' TIMOTHY R.0'MA LEY
:X" =S:Aug st 7,2021 MY CGR4MISSION#GG 117135
Revised 07/15/2014 F ecnded TI u'Jotary public Undery s i. EXPIRES:August 7,2021
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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