HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE-COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \a �� __... - Permit Number:_
MAY 4 �GA�
Building Permit Application
Planning and Development Services ST. Lucie Courltyf PQeM1f:CI.P19
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMITTYPE: LOW VOLTAGE ELECTRICAL
PFRGPOSEU'1' 'PROVEMENT LOCATION: CASTLE PINES POOL z P'x'
Address: 9201 WORLD CUP WAY
Property Tax ID#: 3327-801-0007-000-1 Lot No.
Site Plan Name: CASTLE PINES HOA Block No.
Project Name: CASTLE PINES
DETAILED WORK.
CARD READER, MAG LOCK, PUSH TO EXIT FOR POOL GATE CONTROLLED BY PANEL INSTALLED
IN MEN'S BATHROOM
C,ONSTRUCTIO*N INF'ORMATIONt
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ i � Utilities: —Sewer —Septic Building Height:
011UNER/LESSEE ,CONTRACTOR
Name Castle Pines HOA Name: �Iyj SAtvavf.zt-
Address:9201 World Cup Way Company: (AI�S tTbviei- CICC,h' iC
City: Port St Lucie State: Address:SCCoJ � J"" CT
Zip Code: 38986 Fax: City:L& 1nj2 '(e S State
Phone No.772-489-9501 Zip Code: Fax:
E-Mail:vernonz@langmanagement Phone NoS(A -?)Yt –OWI
Fill in fee simple Title Holder on next page(if different E-Mail 1f)O )O(I .CCAM
from the Owner listed above) State or County License l✓IZ 1361`15(eS
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
P
SUPPLEIVIEN,TAL CONSTR!,UCTION LIEN LAW IN�FORMATI N'i
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:
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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 JOB SITE BEFORE THE FIRST INSPECTION., F YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING UR NOTICE O OMMENCEMENT."
0
Signature of Owner/Lessee/Contractor as Agent for Owner Sig e
STATE OF NEW YORK n STATE OF FLOR DPM
COUNTY OF t IQ55Ceu` COUNTY OF ��ll��((
&Q/4
The forgoing instrument was acknowledged before me The f rgoing instrun as knowledg fore me
this 9 day of 0292) 2019 by this day of 20 by
Name of person making statement. Name of person making statement.
-Personally Known ✓ OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signa u f ary Public-State of .- G r 6f N y�(St�(re �� , �yepubl la�BEf11Hb�?�f�IMAN
1
No.01 LI6300712 I _° `;State of Florida-Notary Public
Commission No.01OW00-7712Wmhad d in Nassau C u�Rynmislio •5 Commission f;GG 3i�73
oF�� mission flfl''bs
Commission Expires Apr. ,2022 ''uinn�` July 30,2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.