HomeMy WebLinkAboutBuilding Dept. ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
0
° Building Permit Application
Planning and Development Services
Building and Lode Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: PSL SPEC 5406 BIRCH DR RESIDENCE
PROPOSED IMPROVEMENT LOCATION:
Address: 5406 BIRCH DR
Property Tax ID #: 3402-609-0182-000-1
Site Plan Name:
Project Name:
5406 BIRCH DR
PSL SPEC
DETAILED DESCRIPTION OF WORK:
SINGLE FAMILY HOME
New Electrical Meter YES Second Electrical Meter NO (Affidavit required)
CONSTRUCTION INFORMATION:
X
Lot No. 4
Block No. 57
Additional work to be performed under this permit —check all that apply:
X Mechanical _Gas Tank _Gas Piping _Shutters X Windows/Doors _Pond
X Electric X Plumbing _Sprinklers _Generator X Roof Pitch
Total Sq. Ft of Construction: 2396 Sq. Ft. of First Floor: 2396
Cost of Construction: $ 252,000 Utilities: —Sewer x Septic Building Height: 6/12
OWNER/LESSEE:
Name or St. Lucie Properties
Address: 201 SW PORT ST LUCIE BLVD
City: PORTSTLUCIE State: FL
Zip Code: 34984 Fax:
Phone No. 772-336-0050
E-Mail: PSLPROPI@GMAIL.COM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: MARK MONTALTO
Company: PORT ST LUCIE PROPERTIES
Address: 201 SW PSL BLVD
City: PSL State: FL
Zip Code: 34984 Fax:
Phone No 772-336-0050
E-Mail PSLPROPI@GMAIL.COM
State or County License CBC1263072
f value
CONTRACTOR:
Name: MARK MONTALTO
Company: PORT ST LUCIE PROPERTIES
Address: 201 SW PSL BLVD
City: PSL State: FL
Zip Code: 34984 Fax:
Phone No 772-336-0050
E-Mail PSLPROPI@GMAIL.COM
State or County License CBC1263072
f value
of
construction is
2500 or more, a RECORDED Notice of
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name: PAUL WELCH JR
Name:
Address: 1984 SW BITMORE
_
Address:
City: PSI State: FL
City: State:
Zip: 34984 Phone 772-785-9888
Zip: Phone:
FEE SIMPLE TITLE HOLDER: 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 County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 Countyand posted on jobsite before the first inspection. If you intend to obtain financing, consult
with lend r attorne efore commencin work or recordin our Notice of Commencement.
ev
"r /, ZZ
Sign re of wner/ ssee/Contractor as Agent for Owner
11
STATE OF FLORI
Luce
COUNTY OF
Swor to (or affir d) and subscribed before me of Physical Presence or _ Online Notarization
r by
thi of , 20941
`3 _YJday
OI c x� ww `
Name of person making statement.
P ally Known � OR Produced Identification
pe of Identification Produced
(Sign ure of Notary Public- State of Florida)
Commission No. (Seal) qt " SHMNONMITTLER
W COMMISSION q GG 20M
*do m= EXPIRES: June11,2022
''�"f;';" 8"Aed TMu Nomry Pift UndwMi"
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETE D
ev