HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8113/20 Permit Number:
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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 APPLICATION FOR: Siding —
PROPOSED IMPROVEMENT LOCATION:
Address: 6603 Santa Clara BLVDFort Pierre, FL 34951
Legal Description: LAKEWOOD PARK -UNIT 9- ELK 117 LOT 20 (NEAP 13!01N) (OR 2262-2113)
Property Tax ID #: 1301-611-0373-000-8
Site Plan Name:
Project Name: _
Setbacks Front
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
Re -Siding house r 5 i a i`,� V 6r 7-1 ` j i�v ! �h
`` ✓ 1 hQroi,c
(t% rCS dCr c`i L✓I i f � , 51
CONSTRUCTION INFORMATION:
Additional work to be er arme un er tI is permit — cneCK all app y:
E1HVAC Gas Tank Gas Piping _ Shutters Windows/Doors
11 Electric 0 Plumbing L_..I Sprinklers ElGenerator Roof Roof pitch
Total Sq. Ft of Construction: 1540 S Ft. of First Floor: 700
Cost of Construction: $ 21,599 UtilitiesSewer Septic Building Height:
OWNERAESSEE:
NameDaniel Markowski
Address:6603 Santa Clara Blvd
City: Fort Pierce State:FIL
Zip Code: 34951 Fax:
Phone No.7-7�
E-M a i is
Fill in fee simple Title Holder on next page ( if Ifferent
from the Owner listed above)
CONTRACTOR:
Name: Mike Holeman
Company: Holeman Inc.
Address: 212 N. US HWY 1
City: Tequesta State:FL
Zip Code: 33469 Fax:
Phone No. 561-743-0687
E-Mail: ivan@holemaninc.com
State or County License: CBC 1250217
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ___1
DESIGNER ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Name:
Address:
City:
Zip: — Phone:
l 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 ant! applicable Home Owners Association rules, bylaws or and covenants that may restNrt or prohibit such
structure. Please consult with your Home Owners Association and review our deed for any restrictions which may apply,
In consideration of the granting of this requested permit, 1 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 your Notice of Commencement.
s
Si o e Lessee/Con actor as Agent for Owner Signature of Contractor/License Holder
�cin,e 1j ar wl��
STATE OF FLORID , / , STATE OF FLORIDA '2
COUNTY OF � titer ! COUNTY OF C� �IYI )�Q4C�
The f__org8pping instrument as acknowledged before me
this clay of •e- , 20 ;�!_by
(Name of person ackn9wledging )
The forgoing instrument was acknowledged before me
this A± day of _J U.n.c . 20 .2r by
N 1CW 1 �6LLD' &_r,
(Name of person acknowledging)
&w S"w)e'-
3igoure of Ni6tary Public- State of Florida ) (Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identific t n
Type of Identifick > ion P odyced Type of Identification Produced �ttttt�Iypr177/
Commission No. f-� 4P (Seal C mission No. .``�\\• •SIGN• 'fC'PO�'��
J1N M. GAYF1 pv7"'i �koi•• C' i
c,- MY COMMISSION # HH 047 5 Z ��1a���,
EXPIRES44ovamb&42.,-2_
Bonded Tt" Notary Publio U
TIC -
Revised 07/15/2014 — aocae4895
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