HomeMy WebLinkAboutBuilding Dept ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Permit Number:
970 dUGC 8 e
O
c ` E E' t�_' Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: PSLSPEC 5708TANGELO RESIDENCE
PROPOSED IMPROVEMENT LOCATION:
Address:
5708 TANGELO CR
Property Tax ID #: 3402-610-0192-000-8
Site Plan Name: 5708 TANGELO
Project Name
PSLSPEC
DETAILED DESCRIPTION OF WORK:
SINGLE FAMILY HOME
New Electrical Meter YES Second Electrical Meter NO (Affidavit required)
CONSTRUCTION INFORMATION:
X
Lot No. 7
Block No, 7j_
Additional work to beperFormed 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 Port 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: 2015W PSL BLVD
City: PSL State: FL
Zip Code: 34984 Fax:
Phone No 772-336-0050
Mail PSLPROPI@GMAIL.COM
State or County License CBC1263072
f value
CONTRACTOR:
Name: MARK MONTALTO
Company: PORT ST LUCIE PROPERTIES
Address: 2015W PSL BLVD
City: PSL State: FL
Zip Code: 34984 Fax:
Phone No 772-336-0050
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: 1984SW 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 County and posted on tbie jobsite before the first inspection. If you intend to obtain financing, consult
with lender an orne fore ommencin work or recordin our Notice of Commencement.
"m000000v/ Z ��O'
Signa re of bwner/ ssee/Co tractor as Agent for Owner
STATE OF FLORI 9
COUNTY OF Lt C(-tom
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Swor to (or affir ed) and subscribed before me of V Physical Presence or Online Notarization
this day of N2Vt%.�, 2QL by
Mc�C Nc Axy\�yvo
Name of person making statement.
Personally Known OR Produced Identification
e Identification Prod ced
(Signature of Notary Public -State of Florida)
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Commission No. (Seal) :iiC'•"'Y''`'e••"'; SHANNONMITTLER
A4`( COMMISSION rt Ori 2mt
. EXPIRES: Junett 2022
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