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HomeMy WebLinkAboutPERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION T0 BE ACCEPTED Date: SffoEou@HE-- +J\=,+i-.+u +J u 4,p E. © R fl ® Z@ -i Permit Number: Building Permit Application Planning and Development Services Building and code Regulation Division Commerc.lal 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Residential Address: 2019 NW LAUREL OAK LN PALM cirv, FL 34990 PropertyTax |D #: 4425-605-0050-000-9 Lot NO. Site Plan Name: Project HARBOUR RIDGE PLAT 6 LAUREL OAK VILLAGE UNIT 17 Name: 2019 MARSIL|A Block No. DETAILED DESCRIPTION OF WORK: ADD ADDITION TO HOME NEW BEDROOM AND BATHROOM New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATloN: 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: Cost of Construction: S 155,000 Sq. Ft. of First Floor: Utilities: Sewer _ Septic Building Height: OWNER/LESSEE:CONTRACTOR: Name RONALD MARSIL|A Name:ANDRE E. MICHELE Address: 13506 NW COCO PLUM CT Company:AEM & ASSOCIATES LLC city: PALM CITY FL State:Address:3 RIDGEWOOD CIRCLE Zip code: 34ggo Fax:NA city: JUPITER state: FL Phone No. 703.624.2313 Zipcode: 33496 Fax: NA E_Mail:RONALLEMARSILIA@GMAIL.COM Phone No 561.745.9591 Fill in fee simple Title Holder on next page ( if different E.Mai|ANDRE@AEMANDASSOCIATES.CoM State or County License 1525027from the owner listed above) lf value of construction is 2500 or more, a RECORDED Notice of Commencement js required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.Nol®ty Pvbtt¢ §`ate ol Florida Expire. 06/11 C022 rfe a,,\,!1 `,,( ,` ,,,' , ,,,\`'Jj`, yJ, :`"-`.,'; .` ; T'`T JI, `.`\ ' `\\' `` `.'i'` /T<\ i\ \.'` 'i.``i '.:'`',\``' „ :.``|i' ;\\`\'t`.+. \ (-/:r" i')('``' ,:> ' i.\ '` '\, '\,````/.` ''|, I h ``r/\ ,).U` `,rtvh/ ``,r,\/,/`'.',(:.-;, .', ,A.1¥-,/`/<,\. ,I.1{``', v,.,,\~`5E\siaN`EE/DEriaiit'EEti: `" ` `= NgE Applicable MORTGAGE COMPANY: Not Applicable N a in e : suMMiT DEsiN & FOF`ENsics iNc.Name. Ad d re ss : 725 sE PORT ST LuciE BLVD suiTE 203 Address. city: PORTST LiclE, state: FL City: State : zi p: 34984 phone 772.285.0572 Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable 80 NDING COMPANY: Not Applicable Name.Name. Address:Address. City.Cit. 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. i#LLccu[cj:#3n:t!:#::w:i:ti|:aowi[eahppryf!ifeTan#tLfi55h#fsgiars:stfgaotaf;pan?i:o:n:trru!;6a#:o#Szi:te:d#:a#;e3s[tgr:tcrht;:n!ua#ri#?#sc:t;gffr,3yttr,ubilusruech ln 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 nan-residential use WApmN|¥oGv:3e°n¥#y:oYu°ruprrfoa;':Leyt.°ARfico°t{geaoNf°ct:C:°infecn°ct#:nncte#::{FeaYer::#e]3Pna¥Lne##:cordsofst. you intend to obtain financing, consultLucie County and posted on the jobsite before the first inspection. If with lender or an attorne before commencin work or recordin Notice cement as Agent for Owner re Contractor/icense Holder STATE OF FLORl COUNTY OF n to (or affl.rmed) and subscribed before me of ¥::a,o:j#:£iei:Of Online Notarization :;---'-= Name of person Personally Known V Type Of identificat.rri statement. OR Produced Identification + (Signature of tary Public-State of Florida ) commission No.G6.aa7 I ial!:ae#:Fr:£:ateo' My Commigsion GG 22 afflffi:ay,:fresAn;er:.r-on" STATE OF FLORIDAcouNTy oF a+. LucH'e Swo_rn to (or affirmed) and subscribed before me of ne Notarization•¥£y Arulre_ E rt\..cheJe Name of person making statement. Personally Known V/ OR produced IdentificationType of ldentifjcatj- sion No.C£G a Traey Laure`te-,__ Comm.ission GG 227 1 99 REVIEWS FRONT COUNTER REVIEW REVIEW PLANS REVIEW VEGETATI0 REVIEW DATE RECEIVED DATE COMPLETED