HomeMy WebLinkAboutAppllicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-3553 Fax: (772) 462-1578
Commercial Residential x
PERMIT APPLICATION FOR: GOOF
PROPOSED IMPROVEMENT LOCATION:
Address.. 5102 INDIAN BEND LANE
Property Tax I D #: 1312-800-0013-000/1
Site Plan Name:
Project Name: WILCENSKI
DETAILED DESCRIPTION OF WORK:
RE ROOF FLAT PORTION OF ROOF IN BASE AND CAP SHEET
Lot No.
Block No.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit –check all that apply:
_Mechanical _ Gas Tank _ Gas Piping
_ _ Shutters _ Windows/Doors Pond
„ Electric _ Plumbing _ Sprinklers
_ Generator YRoof 1112 Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor: �L
Cost of Construction: $ - &0 Utilities: —Sewer _Septic Building Height:
O'W'NERAESSEE:
CONTRACTOR:
Name MARK WILCENSKI
Name: EDWARD LECHNER
Address: 5102 INDAN BEND LANE
Company:EDIFICIUM CONSTRUCTION LLC
City: FORT PIERCE State:
Address: 1215 CASTAWAY BLVD
Zip Code: 34951 Fax:
VERO BEACH
City: State: FL
Phone No.
Zip Code: 32963 Fax:
E -Mail:
phone No 772 643-"4513
Fill in fee simple TitJe Holder on next page (if different
E -Mail EDIFICIUMROOFING@GMAIL.COM
from the Owner listed above)
State or County License CCC 1331308
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER. Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
r]1JlINFR/ I'f1l1Jt[r�rTnd neeen.,-. „
— - — r --• • • • •�Y ++ n. I Iv v I I# MPPI I tdtiuri 85 hereby made to ootaln 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 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an aMrney before commencing work or recordi . ng yookNotice of Commencement,
Signature of Owner/ Lesse tractor as Agent for Owner Signature of Cont /License Halder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF .S �. COUNTY OF wrUiYr
Sword to (or affirmed) and subscribed before me of Sw to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this _� day of SUA 2020 by this I day ofT._ 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Ppoduced
(Signature of Notary Public- Stat
e T O'TARY PUBLIC
11
Commission No. TATE OF FLORIDO
omni GG971143
r o�n� Expires 3/18/2024
REVIEWS I FRONTZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Name of person making statement.
Personally Known L� OR Produced Identification
Type of Identification
Produced
{Signature of Notary Public -State ofFar Nola CipRcoo
q d NOTARY PUBUC
Commission No. NATE OF FLOR41
h
? Comm# GG97114 3
SUPERVISOR I PLANS I VEGETATION ISEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW