HomeMy WebLinkAboutBuilding Permit Application - YoungAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential X
PERMIT APPLICATION FOR:SCIFFIT REPLACEMENT
PROPOSED IMPROVEMENT LOCATION:11000 MYRTLEWOOD LN
Address: 11000 MYRTLEWOOD LN
Property Tax ID #: 3321-501-0026-000-1
Site Plan Name:
Project Name: YOUNG RESIDENCE
Lot No.26
Block No.
I DETAILED DESCRIPTION OF WORK: I
New Electrical Meter NA Second Electrical MeterNA
I CONSTRUCTION INFORMATION: I
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 _
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ to (]0 ao Utilities: _Sewer _Septic
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameYOUNG, ROBERT & CYNTHIA
Name: ROBERT CENK
Address:11000 MYRTLEWOOD LN
Company:HOMECRETEHOMES INC
City: PORT ST LUCIE State: F L
Zip Code: 34986 Fax: I
Phone No. q'7o1 _ Ci lel_o - g (
Address:2162 NW RESERVE PARK TRACE
City: PORT ST LUCIE State: FL
Zip Code: 34986 Fax: 772-873-6686
PhoneN0772-873-6707
E-Mail: ljnun�1kGoc)0l4qiar),C()m
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-MailADMIN@HOMECRETEHOMES.COM
State or County License CGCO62378
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: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Address:
Zip:
Phone:
BONDING COMPANY: x Not Applicable
Address:
City:_
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 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
wI 1 _nder or an-attornev before commenciniz work or r,Adordine vour Notice of Commencement.
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Signs a of Owner/ Lessee/Contractor as Agent for Owner
Signature ofContractor/License Holder
STATE OF FLORIDA
STATE OF FLORIg.
COUNTY OF f-t I Clk-E,
COUNTY OF I ur i e
Swor to (or affirmed) and subscribed before me of
Sworg (or affirmed) and subscribed before me of
✓ P_hysical Presf�nce_or-- Online Notarization
PhyFical Prese ce or_ Online Notarization
thi day of t lRF 2020 by
thi 1� day of 2020 2020 by
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Name of person making st�at ment.
Name of person making state
✓ Identification
Personally Known V OR Produced Identification
Personally Known OR Produced
Type of Identification
Type of Identification
Produced
Produced
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