HomeMy WebLinkAboutSLC Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
9r
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: New Single Family Residence
PROPOSED IMPROVEMENT
OCATiON' -
Address: 9640 Fairwood Court Port St Lucie,FL 34986
Property Tax ID #: 3322-500-0007-000-2 Lot No._
Site Plan Name: Fairwood Court Block No.
Project Name: Delach
New Sinale Family nPtarhar1 n%A101linn
New Electrical Meter X Second Electrical Meter NO
CONSTRUCTION INFORMATIO
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
Total Sq. Ft of Construction: 3887
Cost of Construction: $ 374,900.00
Sq. Ft. of First Floor: 2786
Pitch
Utilities: _Sewer _Septic Building Height: 22'
OWNER/LESSEE:'
Name Joseph and Nancy Delach
Address: 5725 Meyerfield Court
City: Eldersburg Stater
Zip Code: 21784 Fax: N/A
Phone No. (301) 787-1453
E-Mail: njdelach@gmaii.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
L.._I..- -t----`-
----• -
Name: Kimberly Bunner
Company: RJM Custom Homes
Address: 6917 Vista Parkway North Suite #1
City: West Palm Beach State: FL
Zip Code: 33411 Fax: N/A
Phone No (561) 267-7476
E-Mail michael@rjmcustomhomes.com
State or County License CBC1256527
-� -� �• ��••��1 �JUV U1 more, a mtt-uKuru Nonce of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
LJGJIl7IYCK/CNtaINttR: Not Applicable
Name: RICKBOYETTE
Address: 4031 COCONUT BLVD
City: ROYAL PALM BEACH State: FL
Zip: 33711 Phone (561)790-5766
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: PRIME TITLE SERVICES
Address: 1775 SW GATLIN BLVD SUITE #105
City: PORT SAINT LUCIE
Zip: 34953 Phone:(772)621-2&62
MORTGAGE COMPANY:
Name: MID-FLORIDA CREDIT UNION
Address: 1692 SW GATLIN BLVD
City: PORT SAINT LUCIE
Zip: 34953 Phone: (666)913-3733
BONDING COMPANY:
Name:_
Address:
City:_
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 obta' financing, consult
with lender or an attorney before commencing work or recording your Notice of Coryrencement.
I >
Not Applicable
State: FL
x Not Applicable
Signature of Owner/ essee/Contracto gent for Owner Signature of Contractor/L' rise Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
Sworn to (or affirmed) and subscribed before me of
P ysical Presence or Online Notarization
this day of f-2hpcf c2p:. , 202,J by
M (bu (n n e k
Name of person making statement
Personally Known OR Produced Identification
Type o�ldentification
of Notary Public- State
Commission No.
�PRIA DE(,�
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this l day of ' 0 202 I by
tM ('bUn✓')c2
N�of person making statement.
Personally Knowny OR Produced Identification
Type of Ide tification
Produced
riofl p `b N'� (Sign ure of Not 11 Public- State of Flo Ria C E29,
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(SeagH00045 = Commission No. =I(Sial)
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