HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED`'FOR APPLICATION TO BE ACCEPTED
Date: n
Permit Number:
Building Oermit Application �q� j %0
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 v
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ,XP��
PERMITTYPE: RESIDENTIAL
PROPOSED IMPROVEMENT LOCATION: ;
Address: 2802 GROVE DRIVE
Property Tax ID #. 2420-810-0010-000-6 Lot No.10
Site Plan Name: ' l))(C - 5+�� Block No.
Project Name:
DETAILED.DESCRIPTION OF WORK:'
NEW CBS SINGLE FAMILY HOME-3 BEDROOM, 2 BATHROOM, 2 CAR GARAGE
I' CONSTRUCTION INFORMATION':
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
Electric P ul mbing _ Sprinklers _ Generator __--koof 5/12 Pitch
Total Sq. Ft of Construction: 2052 Sq. Ft. of First Floor: 2052
Cost of Construction: $ 200,000 Utilities: _Sewer Zptic Building Height: 18'
OWNER/LESSEE:
CONTRACTOR:
Name JOSE MONTOYA
Name: DANIEL R LEE
Address: 2909 GROVE DRIVE
City: FORT PIERCE, FL State: _
Zip Code: 34981 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Company: DANSAR HOMES LLC
Address: 269 SW IMPALA CT
City: PORT ST LUCIE State: FL
Zip Code: 34953 Fax: 772-446-9283
Phone N0772-37-0512
E-Mail DANSARHOMES@GMAIL.COM
State or County License CRC057512
It value of construction is 5Z500 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:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: PAUL WELCH
Name:
Address: 1984 SW BILTMORE SUITE 114
Address:
City: PORT SAINT LUCIE State: FL
City: State:
Zip: 34984 Phone 772-78s-9888
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not 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 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 YOU ENDER OR AN ATTORNEY BEFORE RECORDING YOUR N TICE OF COMMENCEMENT."
L8fgn_a-fu—re of Owner/ Lessee/Contractor as Agent for Owner
igna ure of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF �� �-1 C�--�_--
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _+� day of M82C 20,2e.�y
this _n day of —1186C 2 by
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identificati
Produced iG(,. 0 (____
Type of Identificatio
Produced
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(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission (Seal)
Commission (Seal)
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DATE
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DATE
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Rev.2/7/19