HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services X
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: Allen / Chambley Residence
PROPOSED IMPROVEMENT LOCATION:
Address: 5507 HICKORY DR
3402-609-0209-000-7 IRE UNIT 08 Lot No. 31
Property Tax ID #:
Site Plan Name: ALLEN / CHAMBLEY RESIDENCE Block No. 57
Project Name: SINGLE FAMILY HOME
DETAILED DESCRIPTION OF WORK:
3.2.2 SINGLE FAMILY HOME
New Electrical Meter X Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
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 6/12 Pitch
Total Sq. Ft of Construction: 3106 Sq. Ft. of First Floor: 3106
Cost of Construction: $ 350,000 Utilities: _ Sewer X Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name JEFFREY ALLEN, LAURA CHAMBLEY
Name: MARK MONTALTO
Address: 713 SE DAMASK AVE
Company: PSL PROPERTIES, INC
City: PORT ST LUICE State: FL
Address: 201 SW PSL BLVD
Zip Cade: 34983 fax:
City: PSL State: FL
Phone No, 772-336-0050 E-
Zip Code: 34984 Fax:
Mail: psipropl@gmail.com
Phone No 772-336-0050
Fill in fee simple Title Holder on next page (if different
E-Mail PSLPROP1@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
Name:
Address: 1984 SW BITMORE ST
Address:
City: PORT ST LUCIE State: FL
Zip: 34984 Phone 772-785-9888
City: State:
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 a d posted on tl jobsite before the first inspection. If you intend to obtain financing, consult
with lender a torne ' ore commencin work or recordin our Notice of Commencement.
Signat
((y a of Owner/ L¢ see/Corftractor as Agent for Owner
STATE OF FLORIDA ST LUCIE
COUNTY OF
Swor (or affir e) �y/subscribed be ore me of Physical Presence or Online Notarization
IF day of� " , 22 by
Namg oil person makin statement.
P onally Known OR Produced Identification
Ky4 of Identification Produced
(Signature of Notary Public- State of Florida
Commission No. (Seal)
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+• as E%PIRES:June 11,2022
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