HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST'BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
Building Permit Application OCT a 6 2017
Planning and Development Services
Building and Code Regulation Division PEHfvlil I INGSt.Lucie Count '
2300 Virginia Avenue,Fort Pierce FL 34982 y, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Building
P.ROPOSED,,IMPROVEMENT LOCATION:
Address: Yucca DR- 510S v LaA p C. -P 3L1 q QZ
Legal Description: INDIAN RIVER ESTATES-UNIT-09-BLK 91 LOT 3
Property Tax ID#: 3402-610-0608-000-8 Lot No.3
Site Plan Name: Boller Block No. 91
Project Name: Boller
Setbacks Front �O I Back: 4O�Right Side: —1, Left Side:-7,
DETAILED DESCRIPTIOUD'F WORK:
FR,
CONSTRUCTION INFORMATION-. E
Additional work to e e orme under this permit—check a app y
rHVAC Gas Tank Gas Piping 1:1_Shutters Windows/Doors
EElectric Plumbing Sprinklers 1:1 Generator Roof Roo�pitch
Total Sq. Ft of Construction: l 'l S . Ft.of First Floor: 'ZA 9.6 10,
Cost of Construction:$ ��-��� Utilities:lnSewer WISeptic Building Height: o2ff b
OWNER/LESSEE: _. . .. CONTRACTOR:
Name-Kurt R Boller Linda'L Boller Name: Karen Gordon•
Address:,7701.Silver Oak DR-� Company:' Paradise Homes Group Y ,
City:'Poit Sf L'ucie'' State:FL 575,NW Mercantile Place#109
Zip Code: 34952 Fax: City: Port'St'Lucie- 'State:FL
Phone No. -77Z 3Sq— 8Y7 Z Zip Coder 34986 " Fax: 7727-621-4664
E-Mail: Phone No..:772=6214663
Fill in fee simple Title Holder on next page(if different E-Mail: Permitting@ParadiseHomesFL.com
from the Owner listed above) State or County License: CGC1518913
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
5 1 � �
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFQRMATION,;t
DESIGNEcRR//iENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: ._1 crS _ Name:
Address: ;�Z PI-J Address: 1110,
City: Co C06 State: F;I;, City: State:
Zip: Phone: — o3-- 7_Qj Zip: Phye:
FEE SIMPLE TITLE HOLDER: — of Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: P e:
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/Lic s Holder
STATE OF COUNTY OF
FLORIDA
�` / „BLS' COUNTYOF �� /
The for ing instrument as acknowledged before me The forgoing instrument was acknowledged before me
this day of d �� 20y this day of ®�i7�g�� 20/Z:by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary1Pu/blic-State of Florida)
Personally Known )(- OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced ggwYg. P •_
/� NOTARY PUBLIC
Commission ��Paula Commission No. %710 8$ TEOFFLORIDA
Q NOTARY PUBLIC COMM#FF970337
a s STATE OF FLORI gl�
a Comm#FF970337
Revised 07/15/2014 �sNCE icil Expires 3/14/2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS