HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
12-28-2020 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: DEMOLITION : SINGLE FAMILY RESIDENCE
PROPOSED]MPROVEMENT LOCATION:
Address: 13505 NW WAX MYRTLE TRL(HARBOUR RIDGE)
Property Tax ID#: 4436-601-0021-000/9 Lot No.21
Site Plan Name: Block No. PLAT 1
Project Name: GALLO RESIDENCE
DETAILED DDESCRIPTIWOF WORK:
COMPLETE DEMOLITION OF EXISTING SINGLE-FAMILY HOME&POOL
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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 _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: EXIST=3,728 A/C,7,498 TOTAL
Cost of Construction:$ 30,000.00 FOR DEMO Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: ' ,CONTRACTOR:
Name DOMENIC GALLO Name:GREG OLDAKOWSKI, PRIES.
Address: 13412 HARBOUR RIDGE DR. Company:GRANDE CONSTRUCTION OF FLORIDA, INC
City: PALM CITY State:_ Address:PO BOX 881765
Zip Code: 34990 Fax: City: PORT ST LUCIE State:FL
Phone No.772-336-7240 Zip Code: 34988 Fax:
E-Mail: Phone No 772-336-7240
Fill in fee simple Title Holder on next page(if different E-Mail GREG@GRANDEFL.COM
from the Owner listed above) State or County License CGC1505127
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.
SUPPLEMENTALCONSTRUCTION'L'IEN LAW INFORMATION:"
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name:ARCHITECTONIC Name:
Address:806 DELAWARE AVE Address:
City: FTPIERCE State: FL City: State:
Zip: 34950 Phone 772.460-7751 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: x Not Applicable
Name:OWNER 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
with lender or an attorney before commencing work or recording our Notice of Commencement.
'n
gna re of Owner/Lessee/Contractor as Agent for Owner S' at re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
x Physical Presence or Online Notarization x Physical Presence or Online Notarization
this 28TH day of DECEMBER ,2020 by this 28TH day Of DECEMBER ,2020 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Pr&duced Pro ced ^^ �
ign ture of Notary Pybl. -_State of Flo ' Ign ture of Notary Public-State of Florida
IN %Ni-RAHMING
Commission No.
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COUNTER REVIEW REVIEW REVIEW'"" "R MESA(—�f0„ram„tom _U •��tE1Wters REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.