HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABL INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
• L-
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 X
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:
PROP SED IMPROVEMENT LOCATION:
Address: &�ERMANY CANAL RD PORT ST. LUCIE, FL 349 2
Legal Description: N 275.58 FT OF S 2310.58 FT OF E 790 FT O F W 890 FT OF W1/2 OF SEC
5.0 ACRES, OR BK 3853-PG 2378
Property Tax ID#: 3229-323-0004-000-2 Lot No. N/A
Site Plan Name: CROUCH SFR MODULAR Block No. N/A
Project Name: CROUCH SFR MODULAR
Setbacks Front 643.63 Back: 105.96 Right Side: 106.33 Left Side: 101.11
DETAILED DESCRIPTION OF WORK:
NEW 40.0'x 68.0' SFR- MODULAR HOME INSTALLATION
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
HVAC _Gas Tank ._Gas Piping Shutters _Windows/Doors
Electric Plumbing Sprinklers _Generator _Roof Roof pitch
Total Sq. Ft of Construction: 2,720 Sq. Ft.of First Floor: 2,720
Cost of Construction:$ 197,000.00 Utilities: —Sewer M Septic Building Height: 15.0'
OWNERAESSEE: CONTRACTOR:
Name JAKE CROUCH Name: CHARLES P. ROGERS _
Address: 1012.SW DEAUVILLE AVE Company: .,PALM,HARBOR CONSTRUCTION
City: PORT ST LUCI .' State: FL Address: 605 S: FRONTAGE RD
Zip Code- 34953 Fax: City: PLANT CITY State: FL
Phone No. 772.216.1346 Zip Code: 33563 Fax: 813.717.9842
E-Mail: JTC.CONCRETEPLUS@AOL.COM Phone No. 813-717.9841
Fill in fee simple Title Holder on next page(if different E-Mail: ALLFLPERMITTING@AOL.COM
from the Owner listed above) State or County License: CBC1253434
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
G .
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: MARK RICHTER Name:
Address: 318 S. SCENIC HWY, STE 100 Address:
City: LAKE WALES State: FL City: State:
Zip: 33853 Phone: 863.589.5980 Zip: Phone:
FEE SIMPLE TITLE BOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
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 you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Ider
STATE OF FLORID ( � STATE OF FLORIDA
COUNTY OF �`�l`s�yY11V<< COUNTY OF
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this l(p" ay of kh_r — 20 (1-by this U� ay of ,20 L-2_by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of—Notary Public-State of Florida ) (Signature of Notary Public-State of Florida)
Personal Know ' / OR Produced Identification Persona II Known OR Produced Identification
Type of Ide' r ication Pfoduced Type of lden i ication Produced
Commission No. �� Commission No. '41?N_OOM
"BLOOM
KhW���•••,�`� MY COMMISSION#00071108 *MY COMMISSION ff G ,21
F� Bonded Tritu Budget NO�ry * � EXPIRES:FeMuary25021
EXPIRES: ry
uj ce
Revised 07/15/2014 Seivioes �lF�Ff4°Q Bonded Ttwu Budget Nota1Y
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE f
COMPLETE
INITIALS