HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r,
Date: 1-31-2018 Permit Number:A�c '-1(!'I��
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RECEIVED
Building Permit Application JAN 31 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
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: 2007 NW Royal Fern Ct., Palm City(Harbor Ridge)
Legal Description: LOT 15, TRACT VA-3, ROYAL FERN VILLAGE, HARBOR RIDGE PLAT NO. 6
Property Tax ID#: 4425-605-0029-000/3 Lot No. 15
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
DEMOLISH AND REMOVE EXISTING HOME AT ABOVE ADDRESS.
CONSTRUCTION INFORMATION:
Additional work toa er orme under this permit—check a appy:
HVAC 11 Gas Tank Gas Piping 1:1Shutters Q Windows/Doors
11 Electric ❑ [i
Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction.$ -71 Soo Utilities: Sewer 0Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name STEINBERG LIVING TRUST Name: GREG OLDAKOWSKI,PRESIDENT
Address:4562 SW HAMMOCK CREEK DR Company: GRANDE CONSTRUCTION OF FLORIDA,INC
City: PALM CITY State:FL Address: PO BOX 881765
Zip Code: 34990��II FaxrL
: p City: PORT ST LUCIE State:F
Phone No.—1-7L_' _1Q " J r YI) Zip Code: 34988 Fax: 772-785-8851
E-Mail: Phone No. 772-336-7240
Fill in fee simple Title Holder on next page(if different E-Mail: GREG@GRANDEFL.COM
from the Owner listed above) State or County License: CGC1505127
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:STEINBERG LIVING TRUST Name:GREG OLDAKOWSKI,PRESIDENT
Address:2007 NW Royal Fern Ct.,Palm City(Harbor Ridge) Address: 4562 SW HAMMOCK CREEK DR
City: PALM CITY State: City: PORT ST LUCIE State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
N a m e:SAME AS OWNER Name:
Address:PO BOX 881765 Address:
City: City:
Zip: Phone: Zip: Phone:
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.
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.
Rus • _"e� X51
gna re of Owner/Lessee/Contractor as Agent for Owner ig ureof Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S'T . l.v c,) COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this/3►`-`day of �?b AK-�/ 20 )1 by this 31"rday of Sh�v.ox,�1 ,20i 8 by
L� C OLDAKc�wSul prts'S. ��2�l� Oco.olc.a►.�Sxl , P��S.
Name of person,rfiaking statement Name of persgn making statement
Personally Known ✓/ OR Produced Identif cati Personally Known ✓ OR Produced Identification
Type of Iden Type of Identification
Produced V Produced
LAA
C7'
a(Signatureof otary Public-State of Florida) (Sign ure of Notary Public-State of Florida)
"""` EN S. NIELSE
Commission No. E
e- ( 1>R 7C - EN S. NIELSEmission No.ommi>sion# FF 1156. ission # FF 1156' 7
My Commiss on Expilc �, My COMMissionT Expire.,, .• June 12, 2018 %""` June 12, 2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17