HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /��
Date: Permit Number: 11043 - D
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Building Permit Application MAR ,0 I mi
Planning and Development Services
Building and Code Regulation Division PERMITTINU
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie Coun�,
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Siding
PROPOSED IMPROVEMENT LOCATIO'N:.
Address: 5710 PAPAYA DRIVE
Legal Description: INDIAN RIVER ESTATES UNIT 09-BLK 79 LOT 8&9 MAP 34/12N OR 796-757-2449-1348
Property Tax ID#: 3402-610-0273-000-0 Lot No.79
Site Plan Name: N/A Block No. 8
Project Name: POMPONI-LIBERATORE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
INSTALL HARDIE PLANK SIDING ON HOME
[-_--C6NS�tRUCTIO* ' R
,NINFORMATIO.N
Additional work toe performed under this permit—check all that appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers E Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: 2886 SFt.of First Floor:
Cost of Construction:$ 24,000 Utilities:n Sewer F]Septic Building Height: 18FT
OWNER
/LESSEE
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''CONTRACTOR•
Name SHIRLEY POMPONI/DOMINIC LIBERATORE Name: MICHEAL HOLEMAN
Address:5710 PAPAYA DRIVE Company: HOLEMAN INC
City: FT PIERCE State:FL Address: 212 N US HWY 1 SUITE 17
Zip Code: 33409 Fax:N/A City: TEQUESTA State:FL
Phone No.772-216-1630 Zip Code: 33469 Fax: 561-743-3787
E-Mail: Phone No. 561-743-3787
Fill in fee simple Title Holder on next page(if different E-Mail: JAMES@HOLEMANINC.COM
from the Owner listed above) State or County License: CBC-1250217
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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wS,UPPLEMENTT
AL'CONSTRUCTi41V LIEN LAVII,INFORMATION
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: x-Not Applicable
Name:wA Name: N/A
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
certify that no work or installation has commenced priorto the issuance of a permit.
St4 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.reviewyour deed for any restrictions.which may apply.
In consideration of the granting of this requested permit,I do.hereby agree that 1 will,,in all respects,perform the work
in accordance with the approvedplans,the Florida'Building Codes and St.Lucie County Amendments.
The following building permit-applications are exempt from'undergoing a full concurrency reviews 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 regult in your paying twice for
improvements to your property.A Notice of.Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain-financing,consult with lender or an attorney before
commencin work or recordingour Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA , STATE OF FLORIDA
COUNTY OFF � COUNTY OFo"
The forgoing instrument was acknowledged before me The for ping instrum ntwas acknowledged before me
this�day of 20 Eby this ay of. 20 by
(Name-of person acknowledging) (Name of person acknowledging.)
(Signature of Notary Public-state of Florida) (Signature of Notary.Public-,State of Florida
Personally Known _OR Produced Identification Personally-Known. OR Produced Identification
Type of Identification Produced D t 4 Type ofldentificationcPlroduced DR-i-10
Commission No.��` �� � (Seal) Commission_No.T-F 7 i; 1V% LS eal.),,,
CATHER)NE E ROSSNIECI: K"'Un, MELANIE QUINN
. ommMsi0lr#EE 8555fl0= -
otary Public-State.ot Florida
Revised 07/15/2014 ExpiresA�rd►3102017 r _ Commission a FF 955-1112
g Tau fan My:Comm.Expires May 17,2020
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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