HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (9 0
Date: G 1 �. l Permit Number: v'� ��
RECEIVED
JUN 0 7 2021
o _
p; •: o . Y _< -, • Permitting Department
Building Permit Application St. Lucie County
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: 'S
PROPOSED IMPROVEMENT P♦�j
LOCATION:,
e6
Property Tax ID#: 3S 21 - tZoc`� - an l2_ -- C� Cc>.[ �� Lot No.
Site Plan Name: %row 0 � ��i crw, �� ��.�� (� Q,S o Block No.
Project Name-_Fv r, V- YC� J •R
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Z— Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Ponds
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
��yy __
Total Sq. Ft of Construction: Gd Coo (5 Sq. Ft. of First Floor: 2,3Z9
Cost of Construction: $ /y �d, �� Utilities: 5K Sewer _ Septic Building Height: P
OWNER/LESSEE: I I I
CONTRACTOR:
Name _Dr3a 1_ jc�I_RW
Name: CJ c��$`�-ot 2>S 1�C,
ddress:
Address:-
Company:_�.y"I
City: 0 y4- State:
Address: �(� _a e , tt,
City: State:��..
Zip Code: W1 /XX i lVb Fax:
Phone No.71—s•� 3 2_1(69
Zip Code: VL 01 fit! Fax::
E-Mail: r� grn �� lbw, I�vfim� ` t♦ LO 9Y�
Phone No �' �6 '� / Zit
Fill in fee simple Title Holder on next page( if different
E-Mail v w\ Ck moLi1 , e
from the Owner listed above)
State or County License GR Ce
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. J `T
SUPPLEMENTAL CONSTRUCTION. -LIEN LAW INF;ORMATIQN:
DESIGN /ENGINEER: �Not Applicable
_
MORTGAGE COMPANY: Not Applicable
Name: :rr
_
Name:
Address 1 ` �
Address:
City: �7`- Lve- `jZJ State:
City: State:
Zip: 'i Phone= 12�-Os 77
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
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.
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 obtain financing, consult
with lender or an attornev before commencine work or recordinw-uaur Notice of Commencement.
ignature of Con for/License Holder
Signature wner essee Contrac r as Agent for Owner
STATE OF FLO�Ij�A
1101.V�-�
STA E OF FLO
COUNTY OF V n
COUNTY OF I,UJ�� l
Sworn to (or affirmed) and subscribed before me of
'V
Swof n to (or affirmed) and subscribed before me of
Physical Preset ce or Online Notarization
this � day of n 2024 by
V /Ph sical Presepce qr Online Notarization
this 1 e • ` day of _ �Yi r— 202 f by
pirri a.I! d f� `I h►�
� Id �u� p ®�
Name of person making staterfient.
Name of person makind statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification 1
Ovi Qn' VtVtj
Type of Iden�,ficatio
Produced A—Okiyel'-
Produced a G2.Y7 &-,-
Lnud2
rio ri(CWSR�
L_4�_
(SignatureW Notary Public- State of Wit, MARYLEEMATTI
(Signature Notary Public- State of Flptrid�) MARyLEE MAIM
11'' a° ''••�•' `� commission # HH 08
Commission No. tT Q Q *
98 a° .•••••.'�
'' II * Commisslon#HH08
2�ommission No. YT 9
m19 ExplresMarch6,2
N al) Expires March6,20
o�� Banded7TuuBudpMNo�q
OF FI
uvloes °
prFOF F`OP� 8aMed1lW BUdg9t N0Tery
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /, C,/
Date: 1/1OI2o2o J Permit Number: 0j) Z C1 / a2
2 LTo EMIE
0 Fc
A OF F2
Building Permit Applicatio %�,� ��63 �®
Planning and Development Services
Building and Code Regulation Division Commercial es den
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATIONTOR: New CBS Single Fan ( Home
Address: Pelican Pointe DR
Property Tax ID #: 3522-700-0012-000-8
Site Plan Name:
Project Name: Kilby Residence
New single family home, three story structure.
New Electrical Meter X Secon Electrical Meter
Additional work to be performe
Mechanical i<Gas an
%Electric API bing
Total Sq. Ft of Constructia : 7654
Cost of Construction:
Lot No. 8
Block No.
c , 364rooh . y. S
under this permit — check all that apply:
k Gas Piping _Shutters Windows/Doors _ Pond
sprinklers _ Generator Roof i'I A Pitch
0,0@0
Sq. Ft. of First Floor: 2634
Utilities: Sewer _ Septic Building Height: 34
' Al � I .ti� 1 Yi >A�i. p , �
�C�� � • � ka+�� 4 �"'��::. ;'tra
Name Donald Kilb
Name: Michael Wiltrack
Address: 7G7 ,A"- otrace br •
Company: Wiltrack Construction and Development Group,LLC.
Address:532 S Colorado Ave
City: s State: i(-
Zip CorL Fax:
City: Stuart State: FL
PhoneD . 35 36
Zip Code: 34994 Fax:
E-Mail
Phone No 888.380.3065
E-Mail Mike@BuildWiltrack.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License CGC1525750
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
NC IN
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: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
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.
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 granfing`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 obtain financing, consult
with len_dpr or an attorney b e commen ' work or recordi . our Notice of Commencement.
Signature of Own r/ Lessee/Contractor as Agent for Owner
IOSighature of Contractor/License Holder
STATE OF FLORIDqPt.
STATE OF FLORIDA
COUNTY OF Mmrt,„
COUNTY OF M.rUn
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this2o day of O C4,0- 2020 by
Physical Presence or. Online Notarization
this Zo( day of 0f4ok� 2020 by
Name of person making statement.
Name of person makin statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Typ"ication.
Pro c d 2-07315*07
Type of Identification
Produced
ture tary e o
' MY COMMIS ION # GG 033096
(rission=;r;o EXPIRE&iember25,2020
C NO. -+•.F Thn11Vo" PubGcUndeiwdter�
(Sign ur of Notary - ION #GG033096
- �'
��rf�� � o?��-EXPIRES September25,2020
Co mission N o. , o� F� o Bonded Thm raIl'}o Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20