HomeMy WebLinkAboutSLC Permit App Windows ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/22/18 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 X
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 1548 NW Sweet Bay Circle, Palm City, FI 34990
Legal Description: Harbour Ridge- Plat 8- Sweetbay Village Unit 17 or 4115-1874
Property Tax ID#: 4426-803-0040-007-7 Lot No.
Site Plan Name: Wallrath Residence Block No.
Project Name: Wallrath Residence
Setbacks Front Back: Bight Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
itiona wor to a er Dime un er t is
�� permit—c ec a app y:
�IHVAC Gas Tank Gas Piping _Shutters Windows/Doors
DElectric LEI Plumbing Sprinklers Generator E] Roof Roof pitch
Total Sq. Ft of Construction: ScFt. of First Floor:
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Cost of Construction:$LA =7. Utilities: _Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Dennis Wallrath Name: Steve Rubin
Address: 1548 NW Sweet Bay Circle Company: Rubin Custom Homes
City: Palm City State: FL Address: 4253 SW High Meadows Ave
Zip Code: 34990 Fax: City: Palm City State:FL
Phone No,1-561-379-8209 Zip Code: 34990 Fax: 866-480-7498
E-Mail:denniswallrath@me.com Phone No. 772-283-0553
Fill in fee simple Title Holder on next page(if different E-Mail: reception1.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 CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: X.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 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.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF CA COUNTY OF
The oin instrum nt w s acknowled e efore me The for oing instr m ill was acknowledgefs efore me
this day of 20 by this day of 20 t r by
(Name p or�ac nowledging j (Name of n a knowledging)
(Signature of Notary P State orida) (Signature of Notary'Public-St Re of Florida j
Personally Known i tcation Personally Known L flR Produced
Type of Identific rA u§ RlyaE Ey Type of Identificat'
�.P #V8'�•' Commission#Ff ,o;�"`�:r-.5 FF9
Commission No. es00t0ber fp1
Fa4��ceB00365.79t9 Commission No. X 6250GtC7tlee806.3g5.70t9
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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