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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Num er:
REC IV ®
' OCT 012021
i
Building Permit Application
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982 ——
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE: Master Building Permit
PROPOSED IMIMIUM
PROUEIVIEt1i1"LOCATIQN! a `
Address: N/A �os--> );J. M Y Va
Property y Tax ID#:N/A V� " _�� /� �- Lot N .N/A
Site Plan Name: N/A Block No. N/A
Project Name: Ravinia 4
Construct a new single family home with 4 bedrooms, 2 bathrooms, and 2 car garage.
per
C®NSTRUCTIONINFORMATION:
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Additional work to be performed under this permit—check all that apply:
X Mechanical . _Gas Tank _Gas Piping _Shutters X Windows/Doors
X Electric X Plumbing _Sprinklers _Generator X Roof 4/12 Pitch
Total Sq. Ft of Construction:2,077 Sq. Ft. of First Floor:living SF 1,620
Cost of Construction:$78,926..00 Utilities: X Sewer _Septic Building Height:
OWNER/LESSEES T _ =CONTRACl`OR �� ', `
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NameSynergy Homes, LLC Name:Synergy Homes, LLC
Address:581 NW Mercantile PI, Suite 106 Company:Synergy Homes, LLC
City: Port St Lucie State: FL Address:581 NW Mercantile PI, Suite 106
Zip Code:34986 Fax: City: Port St Lucie State: FL
Phone No.561-309-8424 Zip Code: 34986 Fax:
E-Mail:jeremy@synergyhomesfl.com Phone N0954-557-9735
Fill in fee simple Title Holder on next page(if different E-Mailolivia@synergyhomesfl.com
from the Owner listed above) State or County LicenseCBC1254289
.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.
SttPPLEM NTA CANS RUC'I'lOi� �,IEN [A1N t t+DR11t ATlO 3
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DESIGNER/ENGINEER: Not'Applicable ' MORTGAGE COMPANY: Not;Applicable
Name:
Lanian uonzates
Name:
Address; l $iL4 mcnara �n Address:
City: ra :5 ;tngs State: Clty State:
Zip: 3 u Phone 06 t"2 -a-n ey
Zip: Phone:,
FEE'SIMPLE TITLE'HOLDER: . Not.Applicable BONDING COWAN Y: Not Applicable
Name: Name:
Address: Address:..City*, City
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT Application is hereby made tgobtain a;perrnit to do the work and'installation as.tndicated..
I certify that no work or installation has commenced prior to the issuance of a permit:
St.Lucie County makes no representation thatis 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 prohlbit such
structure.Please`consuit 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 concurrencyreviewi room additions,
accessory structures,swimming pools,fences,.walls;signs,screen rooms and accessoryuses to another non-residential,use.
WARNING TO OWNER:Your failure to Record a.Notice of Commencement may result m 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 attarne .before commencin work or'recordin � our Notice of Commencement.
ZSig re of Owner/Lessee/Contractor as Agent:for Owner Signature of Contractor/License Holder
STATE OF FLORIDA. ,. STATE OF FLORID .
COUNTY OF `., LuC'aQ COUNTY OF + L oC{:p
ridayof
(or affirmed)and subscribed before me of SW rn to(.or:affirmed)and subscribed'before me of
sical Presence or Online Notarization .Physical Presenceor Online Notarization
AIJqIjq`7—!2024_by this day'of I 202{#Vby
Can 0 Vi'_S Ju an DQ4
Na of person making statement. Named person.ma statement.
Personally Known OR Produced Identification Personally Known /ti OR Produced Identification
Type of tdentrFcation Type of identification
Produced Produced
Si nature'of to Public-State of FdaA
( g ry ature,of Notary ublic-State.of Fl i
Commission No, lj�Z2j OLIVIAFITZGE Ll);
j Mxcot�t[ss�otJ# 3Gd3, ission;Na. HN[2>0 Z3 I�Li:yIA FITZG
EXP712}sS:May 16, 625 (Oi14�95I0N#HH 3 i
a ,: , : cfwsr .ffiLPi1tB3.May 16, 0.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION' SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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