HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34957
Phone: (772) 462-1553 Fax: (772j 467-1578
PERMIT TYPE:
LPROPOSED IMPROVEMENT LOCATION:
Address: 436 Paurotis Lane
Property Tax ID il: 3410-503-0232-000-7
Permit Number:.
Building Permit Application
Commercial Residential .'
Lot No.
Site Plan Name; Block No.
Project Name: Colesan.ti
DETAILED DESCRIPTION OF WORK:
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i
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit –check all that. apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: S
Generator
Sq. Ft. of First Floor.
Windows/Doors
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameCharles Colosanti
Name:Leonard S. Cipolla II
Address -436 Paurotis Lana
Cornpany.Southern Coast Services Inc.
City: Fort Pierce State: _
Address:1804 NW Madrid Way
Zip Code: 34982 Fax:
City: Boca Raton State:FL
Phone No.
Zip Code; 33437 Fax: 561-584-8502
E -Mail:
Phone No 561-584-8455
Fill in fee simple title Holder on next page ( if different
E -Mail infoUsouthorncoastsorvicos.corn
from the Owner listed above)
State or County LicenseEC13008709
If value of construction is 52500 or more, is RECORDED Notice of Commencement 1s required.
If value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement Is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
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:
game:
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.
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 buiid 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 1N YOUR 'PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST 13E RECORDED AND
P05TED ON THE JOB SiTE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY stroiiE RECORDING YOUR NOTICE OF COMMENCEMENT."
Rev. 217119
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Signature of Contractor/License Halder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFPALMOtACtl
COUNTY 0FPm�t+c n
The forgoing Instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 99 day of APF?3L 20 by
this 0 day of AF"K 20�,by
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trONARD S CcPOLLA V
Name of person making, statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signature of NotaryPublic- State of Florida j
{Signature of Ndtb'ry Public- State of Florida)
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Commission Nal L a1j cnmr, lslonIGG t&f
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Xommission No. ' `' � �
i. Exp ,e! May 17, ?a
�, ,- Expl•os May 17,2022
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
-
RECEIVED
DATE
COMPLETED
Rev. 217119
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