HomeMy WebLinkAbout6506 Palomar FP Unit A and BALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
w... J,r
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 6506 Palomar Parkway - Unit A and B
Legal Description: LAKEWOOD PARK -UNIT 12 A- BLK 173-A W 16.50 FT OF S 158.47 FT OF LOT 12 AND E
63.71 FT OF LOT 13(MAP 13/13N) (OR 3639-2559)
Property Tax ID #: 1301-615-0137-000-4 Lot No.
Site Plan Name: Palomar 6506 Block No
Project Name: Palomar 6506
Setbacks Front Back: Right Side: left Side:
I DETAILED DESCRIPTION OF WORK:
Service change - like for like
CONSTRUCTION INFORMATION:
Additional work to be nerformed under this permit — checK all t= apply:
nHVAC Gas Tank ❑Gas Piping El _ Shutters ❑ Windows/Doors
R1 Electric Plumbing Sprinklers n Generator 0 Roof Roof pitch
Total Sq. Ft of Construction: 2400
Cost of Construction: $ 1500
Sq. of First Floor: _
Utilities: L_J'j Sewer El Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name CSC investments Property LLC (TR)
Name: Donald B Green
Address: 1001 SE Monterey RD
Company: Don Green Electric LLC
City: Stuart _ State: FL
Zip Code: 34994 Fax:
Phone No.
Address: 1305 W 1st Street
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-418-5739
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: dongreenelectric@gmail.com
State or County License: EC13007447
,� VO WW %J LLPIMUWAI 101 15 �7L7W or mere, d 1%C%_UKU1tU 1401iCe oT Lommencement 1s required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENICIIYEER: x Not Applicable
Name:
Eri01 TGAGE COIvEPAKir,. of Applicable
Name:
Address:
Address:
City State:
Zip: Phone
City State:
Zip: Phone:
FEE SIMPLE TIIIE HOLDER: Not Applicable
Name:
Address:
BONDING COMPANY: of Applicable
Name:
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 Ncni-dt, I dry hereby agree that I will, ill all respects, per turra tf,e 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 pi-operty. A Notice of Co7mricn ennen# must bc., recoi-died and postcd on t1te j€)bsi G°
before the first inspection. If you intend to obtain financing, consult with [ender or an attorney before
commencing work or recordine your Notice of CnmmanrwmPnt
Slgnur%"of Q�:i r� .('ate ,i:�t.i76 tir iir,�.[?: dS ,fjC:l l�. for �i: �i:;t
5r ji'�ut.11i-'�7it,�ll [iF cet WRIUvt:iiaL: l:til:Ei:i
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MARTIN
COUNTY OF MARTIN
The forgoing instrume t s acknowledged before me
this dal' I
The f r oing instrument was acknowledgeiefore me
cs{.._-._....r 2{� b`r'
tfiisday of ?2Q/ by
DONALD B GREEN
DONALD B GREEN
Name of person making statement
Name of person making statement
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Pro uce- ,
I' YAA
Produ eu
(Sig to Not4ryfic",ida)
(Signat a of o ary Public- State Flori
Commission I4o, (se@[
� 1
Con3rnissir�r t.rs. Seal)
JOY CHRISTINE COPELANd
f�"Y.PV JOY CHRISTME COPELAND
_ Commission #FF948042
: Commission 4FF948042
January
2020
Januar 5,
020
2CFNrNG
REVIEWS
FRONT
SUPERVISOR
PLANS
VEGETATION
SEA TUR L
OVE
COLJNTFR
REVIEW
REVIEW
RFVIEk4i
RFVIEkAf
REVIF!Af
RFVIFW
DATE
RECEIVED
DATE
COMPLETED
Rev, 8/2/17