HomeMy WebLinkAbout004 Building Permit ApplicationAll 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) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: Single Family Residence
PROPOSED IMPROVEMENT LOCATION:
Address: 4700 Indrio Rd. Fort Pierce, FL 34951
Property Tax ]D#: 1418-133-0040-000-7
Site Plan Name: Ross Chambers Norann Chambers
Project Name: Chambers Residence
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
New single family residence which is a 3 bedroom 4 bath 2 car garage home. House is a CBS structure with wood trusses and metal roofing system.
CONSTRUCTION INFORMATION:
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 X Roof 5/12 Pitch
Total Sq. Ft of Construction: 50 5,076 Sq. Ft. of First Floor: 3,436
Cost of Construction. $ 350,000 Utilities: _ Sewer x Septic Building Height: 22'
OWNER/LESSEE:
CONTRACTOR:
Name Ross and Norann Chambers
Name: Jared Modine
Address: 1200 N. FFA Rd
Company: Cole Construction Services, LLC
City: Fort Pierce State: _
Zip Code: 34945 Fax:
Phone No. 772-216-0999
Address: 497 S. Brocksmith Road
City: Fort Pierce State:
Zip Code: 34945 Fax:
Phone No 772-519-0558
E -Mail: rcfence@hotmaii.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail coleconstruction@hotmail.com
State or County License 29778
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
XDESIGN
ER/ENG INEER: Not Applicable
Name: FL Design Build Inspect construction+Architecture
MORTGAGE COMPANY: x Not Applicable
Name:
Address: I
Address:
City: State:
Zip: Phone 772-321-4500
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
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 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 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 ORAN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
_eo/w, ALI'
Si nature of Owner/ Lessee/Contractor as Agent for Owner
Signaure f Contractor/License Holder
STATE OF FLORIDA
STA F FLORIDA
COUNTY OF S* (,Lc(_t`[
COUNTY OF S% Gum.' /
The forgoing instru(�'�ent was acknowledged before me
The forgoing instrument was acknowledged before me
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this 2 7day of J•�• ��, 20ZL by
this _Z day of LV 20 2Q by
Name of person making statement.
Name of person making statement.
Personally Known 1// OR Produced Identification
Personally Known Vf OR Produced Identification
Type of Identification
Type of Identification
Produced
Produ ed 11
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(Signature of Notary Public- Sta. f 1 r-
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Commission No.
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Expires 02/22/2022
+� o� Expires 02/22/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19