HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a C3
Date: J Z —Z L�' .TrTr� �i�r G
Permit Number:
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- Building Permit Applic tiorVAY 2•8 z0 0
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMITTYPE: 5 F
O P
Address: 6702 Donlon Rd Fort Pierce FI 34951
Property Tax ID u: 1301-612-0390-000-6
Lot No.6
Site Plan Name: lakewood park unit10 Block No. 134A
Project Name: Donlon Job
D AI U P CR PT t R
New me 3 bedroom 2 bath home with a 2 car garage
CONST UCTION Nf0
Additional work to be performed under this permit— check all that apply:
X_Mechanical _ Gas Tank _ Gas Piping _ Shutters X Windows/Doors
X Electric X Plumbing _Sprinklers _Generator Y Roof 5/12 Pitch
Total Sq. Ft of Construction: -2145 Sq. Ft. of First Floor: 1439
Cost of Construction: $ $140,000.00 Utilities: —Sewer -) Septic Building Height: 13 feet
OWNER/LESSEE.
OR:
Name_ Kathy Orlousky
Name: Vincent Cimino
Address:-511 Thames Bluff Ridge
Compan tome Inspection Services Inc
City: Fort pierce fl 34982 State: _
Zip code: Fax:
Phone No. 717-448-3115
Address: 5620 Hemingwayct
City: fort pierce FI 34982 State:_
Zip Code: Fax:
E-Mail: na
Phone No 443-277-3254
Fill in fee simple Title Holder on next page (if different
E-Mail VinceiminO yahoo.com
from the Owner listed above)
State or County License 2 2 /Z
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.
DESIGNER/ENGINEER: — Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address- Address: State:
City_ State: City:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER; - _ Not Applicable
Address:
City:
Zip: Phone:
COMPANY:
Address:
Zip: Phone -
Applicable
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 np representation that is granting a permit will authorize the permit holden
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants tl
structure. Please consultwnh.your Home'Owners Association and review your deed for any restric
In consideration of the granting of this requested permit, I do hereby agree that 1 will; in all respec
in accordance with the approved plans, the Florida Building Lodes and St Lucie CountyAmendme.
The following building permit applications are exempt from undergoing a full concurency-review:
accessory structures, swimming pools, fences, walls, signs; screen rooms and.accessory uses to an
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result
irrlproVementsto your property_A-Notice of Commencement must,be record
Lucie'County and posted on the lobslte before the first inspection. If you inter
with lender or an attoyoey before commencing work or recording Your Notice
as Agent
STATE OF FLORIDA.
COUNTY OF
Swom to (or affirmed) and subscribed before me of
- Physical Presence or_Oniine Notarization
this _ &y of 20_ by
STATE OF FLORIDA
COUNTY OF
the,sublect structure
� Ve 2
oAq C Z-�,
Swam to (or affirmed) and subscribed before me of
Physical Presence or online Notarization
this _ day of 20— by
Name of person making statement Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced -
Mil
Commission No. (Seal)
Personalty Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. _(Seal)
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