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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r ,,
Date: 11/8/17 JIt Permit Number:LI
RECEDVED
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Building Permit Application NOV 0 9 2017
Planning and Development Services PER,TITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Renovation
•.PROPOSED IMPROVEMENT LOCATION
Address: 1491 NW Wild Olive Court, Palm City, FL 34990
Legal Description: Harbour Ridge - Plat 13 - Buttonbush Village Unit 13 (or 4005-1423)
Property Tax ID #: 4426-815-0020-000-8
Site Plan Name: Kaufman Residence
Project Name: Kaufman Residence
Setbacks Front _ Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Garage extension and interior renovation of Single Family Residential home per plan.
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to e e orme un er t is ermit — c ec a apply:
ZHVAC Gas Tankas Piping _Shutters Q Windows/Doors
❑✓_ Electric 0 Plumbing Sprinklers Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor: � ES
Cost of Construction: $ o�� (.� Utilities:n Sewer Ll Septic Building Height:
' OWNER/LESSEE:
CONTRACTOR:
Name John & Christine Kaufman
Name: Steve Rubin
Address:1491 NW Wild Olive Court
Company: Rubin Custom Homes
City: Palm City State: FL
Address: 4253 SW High Meadows Ave
Zip Code: 34990 Fax:
City: Palm City State: FL
Phone No. 954-941-3540
Zip Code: 34990 Fax: 866-480-7498
E-Mail:
Phone No. 772-283-0553
Fill in fee simple Title Holder on next page ( if different
E-Mail: reception1.rubincustomhomes@gmail.com
from the Owner listed above)
State or County License: CGC1518190
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
LIPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recordinia vour Notice of Commencement.
s
s
Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA /),J STATE OF FLORIDA /
COUNTY OF " 'I_LtAcl L COUNTY OF _'_ L tC
The forgoing lnstrurpentjwas acknowledge efore me
this —r day of 20 LLby
-I-
(Name f p r
(Signature of I
cknowledging )
Personally Known '
Type of Identification
Commission No.
Revised 07/15/2014
The forgoing instrument as acknowledged before me
this � day of NAQV 120 17 by
(Name of
ng)
e of FIB ''ym (Signature of,Notary Public- S1
r � o /
OR Pro deI Personally Known 1J OR
aced °'� im sBio Type of Identification Produce
41
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(Se °'tis, :�'.• o: Commission No.
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