HomeMy WebLinkAboutBUILDING APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/07/2016 Permit Number:
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 3171 Columbrina Circle, Port Saint Lucie, FL 34952
Legal Description: SAVANNA CLUB -PLAT TWO- BILK 10 LOT 11 (OR 3994-264)
Property Tax ID #: 3425-702-0019-000-5
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side:
Left Side:
I:i
Lot No. 11
Block No. 10
DETAILED DESCRIPTION OF WORK: III
Change out residential air conditioning system
I CONSTRUCTION INFORMATION: III
Z✓ HVAC D Gas Tank E]Gas Piping
Electric 0 Plumbing ❑Sprinklers
Total Sq. Ft of Construction:.
Cost of Construction: $ 3800
Shutters Q Windows/Doors
Generator Roof = Roof pitch
SFt. of First Floor: _
Utilities:11Sewer DSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Mary Noll
Name: David Kruse
Address: 3171 Columbrina Circle
Company: AC Doctors.lnc
City: Port Saint Lucie State: FL
Zip Code: 34952 Fax:
Phone No 1-973-809-0314
Address: 1853 Biltmore Street
City: Port Saint Lucie State:FL
Zip Code: 34984 Fax:
Phone No. 772-344-3944
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: acdoctorsinc@gmail.com
State or County License: CAC058461
venue ue Lunsarucnon is pcDuu or more, a rmc.unueu Notice of t:ommencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Mary Noll
MORTGAGE COMPANY: _ Not Applicable
Name: David Kruse
Address: 3171 Columbrina Cimle, Port Saint Lucie, FL 34952
Address: 3171C0111mbrina Circle
City: PortSaintLucle State:_
Zip: Phone
City: PortSelntLucie State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address: 1853 a11"ore street
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.
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, Green rooms and accessory uses to another non-residential use
WARNING TO OWNER: YouVRr
co a Notice of Commencement may result in your paying twice for
improvements to your p of Commencement must be recordedVpoted on the jobsite
beforethe first ir�pec n.d to obtain financing, consult withfen otorney before
commencing w k o recootice of Commencement.
Rev. 8/2/17
9natf Owner/ see/Contractor as Agent for Owner
Si re of Contractor nse Holder
STATE OF /
OF ORIDA _/%��
COUNTYOFORIDA��
COUNTY OFSTATE
The forgoing instrument was a knowledged before me
The forgoing instrument was acknowledged before me
this 7 day of 20LLf by
this 7 day of 4*— 20 P& by
/yr✓iD /f?✓SG
6.4yi n kR✓56
Name of person making statement
Name of person making statement
Personally Known _ Z OR Produced Identification
Personally Known OR Produced Identification
N4peot Identification
Type of Identification
Produced
Produced
is ture of Notaryublic- ate of Florida)
(Sign t o Notary Public -St of rida )
00P DAVID C SHEPHERD
Commission No. GP MISSIDt��601d57274
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Commission No. r°`ta PUB DAVID CSHEI ER446�
my MMISSION �522T4
°e EXPIRES: December 4,2020
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'A °< EXPIRES: Deumb0r 4, 2020
Bondeol Tlw Budpel NotM$80"S
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17