HomeMy WebLinkAboutSLC Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/27118 Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue,fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION
Address: 2509 NW Hollyberry Lane, Palm City, FL 34990
Legal Description: Harbour Ridge Plat#1 Lot#14 (544-1620 or 3763-1975)
Property Tax ID#: 4436-601-0014-000-7 Lot No.
Site Plan Name: Hrubesch Residence Block No.
Project Name: Hrubesch Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: .g. v� \ .cOv '
AmQ(tiC� �A'N\N 111�ci,�lu�C� w. 1 Lbu3 `C
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CONSTRUCTION INFORMATION:
itiona Workto 1' orme un er t is permit—c ec a app y:
HVAC fj Gas Tank Gas Piping _Shutters z Windows/Doors
Electric �Plumbing Sprinklers E Generator 0 Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction.$ 81,836.00 Utilities: Sewer DSeptic Building Height:
OWN ERAESSEE: CONTRACTOR:
Name Klaus Hrubesch Name: Steve Rubin
Address:2509 Holly Berry Lane Company: Rubin Custom Homes
City: Palm City State:FL Address: 4253 SW High Meadows Ave
Zip Cade: 34990 Fax: City: Palm City State:FL
Phone No.772-224-2773 Zip Code: 34990 Fax: 866-480-7498
E-Mail:klaus@hrubesch.ch Phone No. 772-283-0553 Ext#2
Fill in fee simple Title Holder on next page(if different E-Mail: receptionl.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 CONSTRUCT N LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: of Applicable
Name: Name:
Address: Address:
City: - State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: of 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 Nome Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Nome 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 roperty. A Notice of Commencement must ' e recorded and posted on the jobsite
before the fi inspec i n. If you intend to obtain financing, consult with lender or an attorney before
commencin or'or Wording our Notice of Commencement.
s
Signature of O er/Lessee/Contractor as Agent for Owner Signature of Contractor/license Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFQ:jZ ! 10r,'c COUNTY OF
The f9fgoing instrury t as acknowledged efore me The forgoing instrum t Was acknowledge efore me
this day of 20 by this day of 20 by
K4u_r�,
(NamepMersorl acknowledging) (Name of persona nowledging)
(Signature of Notary Public-St of Florida (Signature of Notary Public-State of Flog )
Personally Known ✓J �rgtd t{gcation Personally Known o�Ri ��fiti�n
Type of Identificati n l? ae ionFF Type of Identification P d1�"' .r; miss+�� b20 0 101�
�xpi[esOClg4Ete}nVA'a nca64R _ b Xpues G roY�a'nlneusa
Commission No. '^' �atn,�ssa Commission No.
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS