HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : Permit Number:
24 dMC�_ C -N.
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 : Bolinsky Residence
PROPOSED IMPROVEMENT LOCATION : Lakewood Park
Address : 8005 Banyan St .
Property Tax ID #: 1301 -603-0087-000- 1 Lot No. 26
Site Plan Name : PSI Bedford Block No . 19
Project Name : Bolinsky Residence
DETAILED DESCRIPTION OF WORK :
3 , 2 , 2 Single family home
New Electrical Meter yes Second Electrical Meter no
CONSTRUCTION INFORMATION :
Additional work to be performed under this permit — check all that apply:
XMechanical _ Gas Tank _ Gas Piping _ Shutters X Windows/Doors _ Pond
X Electric X Plumbing _ SprInIders _ Generator X Roof 6/ 12 Pitch
Total Sq . Ft of Construction : 2073 Sq, Ft. of First Floor: 2073
Cost of Construction : $ 234 , 900 Utilities: _ Sewer X Septic Building Height:
OWNER/LESSEE , CONTRACTOR :
Name Brynn & David Bolinsky Name : Mark Montalto
Address : 6006 Indrio Rd . ,#6 Company: PSL Properties Inc.
City: Fort Pierce State : FI Address : 201 SW Psl Blvd .
Zip Code : 34951 Fax: N/A City: PSL State : A ,
Phone No. 77 Zip Code : 34984 Fax: N/A
� my�E-Mail : c�tti� } G� �aL 1 tts i ,'k 4� o /A Phone No 772-336-0050
Fill in fee simple Title Holder on next page ( if different E-Mall pslpropl@gmail . com
from the Owner listed above) State or County License CBC1263072
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION :
DESIGNER/ENGINEER : _ Not Applicable MORTGAGE COMPANY: X Not Applicable
Name : Paul Welch Inc . Name :
Addres : 1 more St, Address :
City : I State : FI . City : State :
Zip : 34984 Phone 772-785.9888 Zip : Phone :
FEE SIMPLE TITLEHOLDER : X Not Applicable BONDING COMPANY : X 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 Countyy makes no representation that is granting a permit will authorize the permit holder to buiid the subject structure
which is in con tlict 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 anj posted on the ' bsite before the first Inspection . If you intend to obtain financing, consult
with lender ckfin aMorneV bOOe commencing work or recording o r oti of Comirnoricement ,
Signatu of Owner/ Less /Contractor as Agent for Owner Signature of Contractor/Lic .nse Holder
STATE OF FLO !! STATE OF FLORIDA \
COUNTY OF e C I f9CAF COUNTY OF � - IAA ? CAP,
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
,A Physical Presence or online Notarization X Physical Presence or Online Notarization
this a day of 2021 by this �,2' day of 2020 by
6ARr �' M&A, LPi JY2 VYHWk,- Wc/irg F-P 176
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signa ure of Notary Publ -! F QBowen (Signature of Notary Public- S texpf for
,p !dy Commission GG 208212 ¢ Diary Puh11c Slats W Ronda
o• Exp a 0 04/2023 obin Bowen
Commission No. �G �� �e Commission No. LC� 1 ,Ak
o, pd� Exp�04/2 23 288212
04Y1023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev, 5/6/20