HomeMy WebLinkAboutPermit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
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 TYPE: New Single Family Residence
Address: 9624 Knollwood Lane
Property Tax ID #.. 1327-701-0024-000-3
Site Plan Name: Knollwood Lane
Project Name: Stawsky
New Single Family Detached Dwelling
3 Bed room/3Bathroom s/2 Car Garage
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping Shutters
Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction: 3044
Cost of Construction: $ 323,900.00
Name Roger & Ann Stawski
Address:12605 314th St
Sq. Ft. of First Floor: 2161
Lot No.54
Block No. 27
Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height: 22'
City: Lindstrom MN State: _
Zip Code: 55045 Fax:
Phone No.612-719-7385
E-Mail: rogerstawski@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Kimberly Bunner
Company:RJM Custom Homes
Address:6917 Vista Parkway N #1
City: West Palm Beach
Zip Code: 33411 Fax: _
Phone No561 267-7476
E-Mail Michael@rjmcustomhomes.com
State or County LicenseCBC1256527
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
State: FL
DESIGNER/ENGINEER: _ Not Applicable
N a m e : RICK BOYETTE
Address: 4031 COCONUT BLVD
City: ROYAL PALM BEACH State: FL
Zip: 33711 P h o n e 561-790-5766
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: PRIME TITLE SERVICES
Address: 1775 SW GATLIN BLVD STE #105
City: PORT T LUCIE
Zip: 34953 _ P h o n e: 772-621-2882
MORTGAGE COMPANY: _ Not Applicable
Na me: Mid Florida Credit Union
Address: 771 St Lucie West Blvd
City: PSL State: FL
Zip: 34986 Phone: (866) 913-3733
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
---- -ter•/ �.vr� r 1 Vn mrrluv11 ;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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Ow r Lessee/Contractor as Agent for Owner Signature of Co tr ctor/License Holder
STATE OF FLORIDA STATE OF FLO IDA
COUNTY OF PALM BEACH COUNTY OFPALM BEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20_ by this day of 20_ by
Kimberly Bunner Kimberly Bunner
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification
Produced Type of Identification
Produced
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7 1