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ALL APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BEACCEPTED
Date: )7 Permit Number:
1-7 ) I- 0S-6 Y
Building Permit Application NOV 21 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Building
Address: 13192 NW WHEATON LANE -M
Legal Description. RIVERBEND (PB 67-36) LOT 3
Property Tax ID #: 4425-703-0008-000-1
Site Plan Name:
Project Name:
Setbacks Front40' Back: 41.68' Right Side: 45.69'
Left Side: 64.7,
YDETAILED DESCRIPTfON OF WORK :; Y1
SINGLE FAMILY CBS 2 STORY 5 BEDROOM 4 BATH 3 GARAGE
RJHVAC I Gas Tank
R] Electric 0 Plumbing
Total Sq. Ft of Construction: 5386
Cost of Construction: $ 587,700.00
mis permit— cnecK au i ar apply:
Gas Piping _ Shutters
RJSprinklers Generator
S . Ft, of First Floor: 2098
Utilities:]Sewer Z Septic
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
✓Q Windows/Doors
R1Roof 2�5 Roof pitch
Building Height: 27.10
5c
S"UPPLME L`CONSTRUCI'ION LIEN LAW INFORMATfON f
DESIGNER/ENGINEER: _ Not Applicable r. MORTGAGE COMPANY: _ Not Applicable.
Name: Victor Hernandez Name:
Address: 1600 S Dixie Hwy STE 400 Address:
City: Boca Raton State: FL City: State:
Zip: 33432 Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable .BONDING COMPANY: _'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 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) will, in all respects, perform the work
in accord ance"with-the approved plans, the Florida_Ruilding 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection, If you intend to obtain financing, consult with lender.or an attorney before
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLOIRIDA
STATE, OF FLORIDA
COUNTY OF s- %'
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this I� day. of fI%. 20 !:'by
this /J' day of 20 :lby
y.
Name of person making statement.
Name of person making statement
Personally Known : X` OR Produced Identification
Personally Known ,X OR Produced Identification
Type of Identification
Type. of Identification .
Produced
Produced
(S,ignature of Notary - State' -of Florida)
(Signature of Nota y fllrr te-e€ Flood
;r�:'�Y4, SIV ACli�1Fd
Commission No. .. ��eaT!'....
SIVAN SHACNAR
Commission No. :�. :�= MYCUMMISSI&AG082944
Y COMMISSION # GG082944
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3,�:T,, •' EXPIRES April 10, 2021
EXPIRES April 10, 2021
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Rev. 8/2/17