HomeMy WebLinkAbout1. BuildingPermitApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
T. LlIC1E
A
OCI�I THY
D
Planning and Development Services
Permit Number:
Building Permit Application
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Single Family Residence
PROPOSED IMPROVEMENT LOCATION:
Residential X
Address: 2637 Dyer Rd. Port St Lucie, FL. 34952
Property Tax ID#: 3414-501-1405-350-2 Lot No.5
Site Plan Name:
Project Name: FY792
Block No. 2
DETAILED DESCRIPTION OF WORK:
Construct a new single family home with 4 bedrooms, 3 bathrooms, and a 2 car garage.
New Electrical Meter X Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 2,694 Sq. Ft. of First Floor: living SF 2,069
Cost of Construction: $ $102,372.00 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Synergy Homes, LLC
Name: Synergy Homes, LLC
Address: 581 NW Mercantile PL, Suite 106
Company: Synergy Homes, LLC
City: Port St Lucie State: _
Zip Code: 34986 Fax:
Phone No. 954-557-9735
Address: 581 NW Mercantile PL, Suite 106
City: Port St Lucie State:
Zip Code: 34986 Fax:
Phone No 954-557-9735
E-Mail: Jeremy@synergyhomesfl.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail olivia@synergyhomesfl.com
State or County License CBC1254289
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
Name: Lillian uonzaies
Address: i oz4 hicnara Ln
City: ralm aprings State: rL
Zip: 664U0 Phone 510 1-L4J-byLy
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:_
MORTGAGE COMPANY: n Not Applicable
Name:_
Address:
City:
Zip:
Phone:
State:
BONDING COMPANY: n Not Applicable
Name:_
Address:
City:_
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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult 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 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 the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencing work or recording vour Notice of Commencement.
Sign `ure of Owner/ Lessee/Contractor as Agent for Owner
SignatiYre of Contractor/License Holder
STATE OF FLORIDA �,
STATE OF FLORIDA
COUNTY OF (. L I
COUNTY OF __
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this Q_ day of C2 f , 202(Zby
this i_ day of _.) Ctyl uq rU 2022by
Cen *mS
(�Q V1 tDt)LV S
NaMe of person making statement.
Name of person making statement.
Personal) Known y �_ OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of ry Public- State of
�nature of Notary Public- Stat
_ OLIVIA FITZGE
Commission No. �� I�JU �35 al4YCOMMISSION9HH1
LD r a r , ., =°��° OLIVIA FITZGERALD
0�O mission No. lYi I `'�j �� (+f 1�IMISSION#HH130235
EXPIRES: May 16, 2
25 "F°FFo�° EXPIRES; May 16, 2025
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Rev. 31 o/ 1-u