HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/22/2020 Permit Nul
MAY 12020
-- — Building Permit Ap lication
Planning and Development Services Permitting L)epElrtment
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: Carport and Shed
Address: 7637 Eastern Bluebird Dr, Port St Lucie - lot 7210
Property Tax ID q: 3424-800-012'1- ow /, Lot No. 11
Site Plan Name: Block No. 72
Project Name:
Additional work to be performed under this permit — check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 25,000
_Sprinklers _Generator _Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER%LESSEE'Savafin' agCes',j2el;reat;LL`C ,t». ,
C,QNT,R
Name Savanna Eagles' Retreat LLC
Name: Roger W Shull
Address:27777 Franklin Rd, Ste 200
Company: Shull Construction of Orlando, Inc.
City: Southfield State: _
Zip Code: 48034 Fax:
Phone No.
Address: PO Box 621851
City: Oviedo State: FL
Zip Code: 32762-1851 Fax: 407-365-6278
Phone No407-365-4078
E-Mail:
Fill in fee simple Tiile Holder on next page (if different
from the Owner listed above)
E-Mail mel@shullconstruction.com
State or County License CRC052310
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.
SUPFLEMENTALCON51RUCfIOIV`'LIENLAVVINFORMATI"ON`
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DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name' Frank Cleamn- Dams 8 Clealon
Name:
AddreSS: 101 Sunnylown Rd. Ste 109
Address:
City: Casselberry
State: FL
City:
State:
Zip: 32707 Phone 407-539-2353
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
of 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 priorto 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.
Inconsideration 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. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sigfiature of Owner/ Lessee/Contractor as Agent for Owner
Sigifature of Contractor/License Ho r
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Seminole
COUNTY OF Seminole
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 22 day of April 20_ by
this 22 day of Apol
20_ by
Roger W Shull
Roger W Shull
Name of person making statement.
Name of person making stat
I.w"•,•,•�� MELODY L. DAUGHERTY
1c`@d
Personally Known 1 .,; •R RflBFb6�El h�,PL6F1ffR8Yion
Personally Known x O
Pgo Wro�jg631371A
Type ofIdentificatio 71 �;Commission#GG313218
Type of Identification
Expires July17,2023
Produced ' pirmJulyV, 2023
Produced
?`a 1`.• Bonded TMu7roy Fainlasuranceilo0.3
Banded Thru Troy Fain Insurance 800-305.7019
(Signature of 11otary PubIWState of Florida )
(Signature of N Lary Public -(Skate
3f Florida )
Commission No. GG313218 (Seal)
Commission No. GG313218
(Seal)
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