HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED +
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�! Date: 9/20/17 Permit Number: I
Building Permit Application �� S
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 FOR: Renovation
PROPOSED IMPROVEMENT LOCATION:
Address: 2007 NW Laurel Oak Lane, Palm City, FL 34990
Legal Description: Harbour Ridge-Plat 6-Laurel Oak Village Unit 23(Map 44/26N)(OR 4014-2520)
Property Tax ID#: 4425-605-0056-000-1 Lot No.
Site Plan Name: Shearer Residence Block No.
Project Name: Shearer Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION.OF WORK:
Interior renovation of Single Family Residential Home. Please see attached detailed Spreed sheet and
plans.
CONSTRUCTION INFORMATION:
Additionalworkto e e orme un ert ispermit—c ec a apply:
�HVAC 11 Gas Tank [:]Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing []Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor: �.
Cost of Construction:$3 q ,0 0 C) Utilities:In Sewer[]Septic Building Height-
OW
N'ER/LESSEE: CONTRACTOR:
Name Fredrick Shearer Name: Steve Rubin
Address: Rubin Custom Homes
F
City:pI'"' OC.J►rl State: dress: 4253 SW High Meadows Ave
Zip Code: 34990 � City: Palm City State: FL
Phone No. 612-616-3971 ! Zip Code: 34990 Fax: 866-480-7498 i''
E-Mail:fredjshearer@gmail.com Phone No. 772-283-0553
Fill in fee simple Title Holder on next page(if different E-Mail: reception1.rubincustomhomes@gmail.com
from the Owner listed above) State or County License: CGC1518190
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCT N LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: of 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.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Ho der
STATE OF FLORIDA STATE OF FLORIDA /�
COUNTY OF ' , 6�r�I f, COUNTY OF 1 I O AI _
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_g&day of 20 LZby this�0 day of 30'r ,20 I_q_by
1 stcxIF P 6-IJ S r
(Name o on ack owledging) (Name of perso know) dging)
(Signature of Notary Public-State Of Florida) (Signature of Notary Publl-State of W rida)
Personally Known ''/ OR Pr dentifi ation Personally Known ✓/ OR Pr dentificati
Type of Identification Pr Type of Identification Pr
Commissi SyERRsson#FF9��Q � ��to�9 Commission .,: `"° ',5�o
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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