HomeMy WebLinkAboutBuilding Permit Application i c ,
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /�
Date: Permit Number: ���1 • NE
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 APPLICATION] �.,2y ()) FOR: [Building , P��„�a
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Address: 2505 NW Hollyberry LN
Legal Description: Harbour Ridge Plat No 1 Lot 16 ( OR 3624-2483; 3631-733 )
Property Tax ID#: 4436-601-0016-000-1 Lot No. 16
Site Plan Name: Harbour Ridge Block No.
Project Name: Harbour Ridge
Setbacks Front Back: Right Side: Left Side:
remodel laundry,hallway,guest bedroom closet. add 24.78 sqft of to AC space. Demo,New
plumbing,electrical,drywall,tile,new cabinets,trim, paint, as per Kelly & Kelly Architects plan
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Additional work toa er orme under this permit—check a appy:
❑✓ HVAC E]Gas Tank Gas Piping _Shutters Windows/Doors
ZElectric 0 Plumbing Sprinklers El Generator El Roof
Total Sq. Ft of Construction: 0 SFt.of First Floor:
Cost of Construction:$ 30,000.00 Utilities:Sewer Septic Building Height:
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Name Maureen E Olson (TR) Name: Jeffery James Pauly
Address:2505 NW Hollyberry LN Company: Jeffery J Pauly Construction Inc.
city: Palm City State:FL Address: 2420 SW Maplewood Dr.
Zip Code: 34990 Fax: City: Palm City State: Fl.
Phone No.772-336-0685 Zip Code: 34990 Fax: NA
E-Mail:Olson_maureen@yahoo.com Phone No. 772-263-8268
Fill in fee simple Title Holder on next page(if different E-Mail: jjpcbc.jp@gmail.com
from the Owner listed above) State or County License: CBC 047770 #10811
If,value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Kelly & Kelly Architects Name: NA
Address:119 SW 6th Street Address:
City: Stuart State: FL City: State:
Zip: 34994 Phone: 772-283-3492 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: NA Name: NA
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 jobsite
before the first inspection. If y 'ntend to obtain financing,consult with lender or an orney before
commencin work or rmrdinwvour Nptice of Commencement.
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Si re f er/Les a Agent Sign of act /Lic s Holder
STATE OF FLORIDA STATE OF FLORIDA ,
COUNTY OF COUNTYOF
The forgoing instrument was acknowledged before me The forgoing instr ment was acknowledged me
this ASday of 20 Llby this8c day of 20 by
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(Name o p n ac owledging) (Name ofors c ledging)
\Kigriature of Notary Public-Aate of Florida) (Signature of Notary Public-St a of Florida)
Personally Known OR Produced Identification " Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No.
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NotaryA INGRAM
Y Com a e oI Florida
.� ao;� Co m.Expires Dec 20
Revised 07/15/2014 "'" �� Bondedmmissio 249018
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DATE 'No',1410 Bondetional Not1
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