HomeMy WebLinkAboutBuilding Permit Application 11-3-21All APPLICABLE INFO MUST BE COMPLI,FOR APPLICATION TO BE ACCEPTED
Date:
S-f: L(aCI E
F 11O R 1 U A
Permit Number: 2110-0305
RECEIVED
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce F134982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial xx Residential
CBDG Funding
NOV 0 3 2021
St. Lucia county
PeiFiil i► b
PERMIT APPLICATION FOR:.,
} PROPOSED IMPROVEMENT LOCATION:
Address: 12600 Harbour Ridge Blvd Palm City, FL 34990
Property Tax ID #: 4426-807-0000-000-7 Lot No.
Site Plan Name: South Shore Pool House renovations Block No.
Project Name: South Shore Pool House renovations
DETAILED DESCRIPTION OF WORK:
Pool House passthrough per plans 1 P C
C. ,
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Mechanical Gas Tank Gas Piping Shutters
Electric Plumbing Sprinklers Generator
Total Sq. FtofConstruction:
Cost of Construction: $8500.00
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pith
Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR`::':
Name South Shore Village
Name: Robert Dunlap
Address: 13301 NW Maplewood Lane
Company: Rubin Custom Homes
City: Palm City State: FL_
Address: 4253 SW High Meadows Ave
Zip Code: 34990 Fax: 772.336.1469
City: Palm City State: FL
Phone No. 772.873.6016
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 arubincustomhomes@gmail.com
from the Owner listed above)
State or County License 1529565
ITvaweorconstruction is Z50oor more, a RECORDED Notice otCommencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
OWNER% CONTRACTOR AFFIDVR: AppllcaUon is hereby madeto obtain a permittodo theworicand installation as indicated.
1 certify that no wodcorinstallaUon has commenced priortothe fssuanceof a permit.
St.lauteCountvmakesnorepresentationthatisgranttnga ermltwiUa,, orizethe ermitholder sltlat ayrouild esub]eds'ucture
su
fl bylaws or a�covenanisthatmayrestrietorpro lbitsuch
which lsin Con lctwlth any applicable Home OwnersAssoe aUon rotes, h
structure. Please consult th your Home Owners Association and revlewyour dee or anyrestrictionswhlc may app y.
In In aceeordana a with he approved plans�the p da Bu id ng Co eesnd St lucleCountyAmeaddments. perform thework
room additions,
The following building permitappiications are exempt from undergoing a full concurrency rev)exr,
accessory structures, swlmming pools, fences, walls, signs, screen roomsand accessory usesto another non4eessi ice ialp
WARNING TO OWNER: your failure ARNotice o CommenCementmust be recorday ed in the public records of St.
imorovements to your rop _ rty; c_r Commencement
en emen rnu If you intend to obtain financing, consult
STATE OF FLORIDA' Air+lY1
COUNTY OF C"
m to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Lhis,U_ day of 2o21b by
-Name of person making statement,
personally Known /` OR produced identification
Type of Identification
Prods[ d KELLIEHOFFMAN
to rlic - State of =.orica
e
(Signature o .� v i My Camm•. -Xplr02 Hati nil Votary Assr .
commission o.
STATE OF FLORIDA ,,, 1•
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
_)�_Physlcal Presence or Online Notarization
this I I day Of �`A�_- 201 by
Name of person making statement
Persona%/Kndwrt_i •_ORProducedidentification
Type of identification
Produced—� ��y�,�.
commission
Commission
My Comm. Expin
ed through ratio
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