HomeMy WebLinkAboutBuilding Permit Application 1-25-16ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEI_:D JAN 2 5 Z�16 �� 7
I
Blue ding Permit Application
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
PROPOSED INPROVEMENT LOCATION:
Address: 3005 NW Radcliffe Way
Legal Description. Riverbend Plat Book 67 Page 36 City of Port St: Lucie, St. Lucie County, Florida
Property Tax ID #: 4425-703-0051-000-7
Site Plan Name: Riverbend
Project Name: Riverbend
Setbacks Front 40.00 Back: 61.12 Right Side: 13.78 Left Side: 13.69
Lot No. 46
Block No.
[DETAILED DESCRIPTION OF WORK:
New Construction-SFR S &C)rta� LX 3� � . 3 e ��o•!`-� e,
Model 6811-D/R
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit -check all apply:
❑✓— HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
Electric ❑✓_ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: ,0(A S . Ft. of First Floor:
Cost of Construction: $ 373,000.00 Utilities:�Sewer W1 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Standard Pacific of South Florida
Name: Richard Manning Woodley
Address: 825 Coral Ridge Drive
Company: Standard Pacific of South FI GP, Inc.
City: Coral Springs State: FL
Zip Code: 33071 Fax: 954-434-8840
Phone No. 954-232-2290
Address: 825 Coral Ridge Drive
City: Coral Springs State: FL
Zip Code: 33071 Fax: 954-434-8840
Phone No. 954-232-2290
E-Mail: Permits@brownspermitting.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Permits@brownspermitting.com
State or County License: CBCA17970
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
V1
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City:
Zip: Phone:
State:
BONDING COMPANY:
Name:
Not Applicable
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first lisp urio
. If you intend to obtain financing, consult with lender or an attorney before
commencing k rrdilag.vour Notice of Commencement.
Signature of Own r/Agent/ Lessee Signature of Contra or/License Holder
STATE OF FLORIDA
COUNTY OF Broward
The forgoing instrument was acknowledged before me
this IC day of X)e � 20=by
Michael Metzkes
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
STATE OF FLORID
COUNTY OF ', I
The forgoing instrument was acknowledged before me
this_" by of e"Jg -P/ , 20uby
Richard Manning Woodley
(Name of person acknowledging)
(Signature of N ary Public- State of Florida_.)
Personally Known x OR Produced Identification
Type of Identification Produced 11
Commission No. , jN SHACHAR I lCommission No.
s MY COMMISSION #FF00702611
Revised 07/15/2014 (407)39e•0163
a (MY COMMISSION # EE 2247
IRES: August 14,201
Bonded Thor Notary Public Unden
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
Y y
DATE
COMPLETED