HomeMy WebLinkAboutPERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
`L, LLi CLL
z Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: S;^91e. �ar1�di
PROPOSED IMPROVEMENT LOCATION:
Address: 10210 Carlton Rd.
PrnnPrty Tax ID #: 4210-212-0002-000-2
Site Plan Name: 10 37 38 W 1/2 OF NW 1/4 OF NE 1/4 OF NW 1/4 (5.08 AC
Project Name:
DETAILED DESCRIPTION OF WORK:
Single Family Residence q-2-- I
New Electrical Meter %/ Second Electrical Meter
CONSTRUCTION INFORMATION:
V/
Lot No._
Block No.
Additional work to be performed under this permit– check all that apply:
_✓Mechanical _ GasTank _ Gas Piping _ Shutters _ Windows/Doors _Pond
+/ Electric Plumbing _ Sprinklers _ Generator ✓Roof Pitch
Total Sq. Ft of Construction: 2)) ( 03 Sq. Ft. of First Floor:
Cost of Construction: $ x--38", ooC> Utilities: —Sewer 'GSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name George and Angela Martire
Name:John A. Groza
Address: 1711 SW Carvalho Street
Company:Groza Builders,lnc.
City: Fort Pierce State: _EL
Zip Code: 34987 Fax:
Phone No. 772-643-3699
Address:511 SW PSL Blvd.
City: Port St.Lucie State: FL
Zip Code: 34953 Fax:
Phone No772-336-7653
E-Mail:Gmartire2@outlook.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-MailTony@grozabuilders.com
State or County License CGC1 524734
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: _ Not Applicable
N a m e: Vhristopher Beers
MORTGAGE COMPANY: _ Not Applicable
Name:
Addres s:5109 Grand Peimatto Way
Address:
City: North Port State: FL
Zip: 34291 Phone941-628-0635Zip:
City: State:
Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: 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 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
withlenrieroranattornevbeforommencingwork or recordingvour Notice of ommencement.
ev. 0
Sign /U re of Owner/ Lessee/Co4ractor as Aidnt for Owner
Sigiature ofontractor icense yder
STATE OF FLORIDA
STATE OF FLORIDA
S-
COUNTY OF S+ -I A C. I
COUNTY OF uA r i'C
worn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization,Prysical
Pre`s�nce or Online Notarization
"I (--, 2020 by
his day of NOV P bP � , 2020 by
this day of NOV �N1—�
Jo\1%(\ PKyVV\/n')nu► C-Zro--
) uy n orn+yi on �A �-zrvZc-,..-
Name of person making state nt.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known % OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary P -State of Flori
tg a ure of Notary Pu ic- ate of FI gRIANNAGRAH
BRIANNAGRAH
OMISSIN �G Commission No. 668qI 1OS
`IO / UMISSIO#G'
fission No.jC7)pp1 5-- MY COM
EXPIRES: APR 02,
:
_ EXPIRES: APR 02,
r .,,.`' r E
�,,, � Bonder, through 1st SStu
throw h1ststateInsur2nce
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 0