HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLLSE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `r` Date: • ) 10 Permit Number: A • u �. 77
RECEIVED
Building Permit Application JUN 2 1 2016
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: 3050 NW Radcliffe Way
Legal Description: Riverbend Plat Book 67 Page 36 City of Port St. Lucie, St. Lucie County, Florida
Property Tax ID #: 4425-703-0019-000-1
Site Plan Name: Riverbend
Project Name: Riverbend
Setbacks Front 40.00 Back: 193.89 Right Side: 15.00 Left Side: 15.00
DETAILED DESCRIPTION OF WORK:
New Construction-SFR
Model 6812-D/R (kitchen right)
Lot No.14
Block No.
CONSTRUCTION INFORMATION: III
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❑✓_ HVAC Gas Tank ❑Gas Piping _ Shutters a Windows/Doors
RIElectric ❑✓— Plumbing Sprinklers E Generator W3 Roof
Total Sq. Ft of Construction: �S �� S . Ft. of First Floor:
Cost of Construction: $ 513,000.00 utilities:Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Standard Pacific of South Florida
Name: Scott Harala
Address: 825 Coral Ridge Drive
Company: Standard Pacific of South FI GP, Inc.
City: Coral Springs State: FL
Address: 825 Coral Ridge Drive
Zip Code: 33071 Fax: 954-434-8840
City: Coral Springs State: FL
Phone No. 954-232-2290
Zip Code: 33071 Fax: 954-434-8840
Phone No. 954-232-2290
E-Mail: Permits@brownspermitting.com
E-Mail: Permits@brownspermitting.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CGC1506052
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
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Name: AB Design Group, Inc,
Address: 1441 N. Ronald Regan Blvd.
City: l onewood State: FL
Zip: 32750 Phone: 407-774-6078
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip Phone:
t y5
MORTGAGE COMPANY: Nat Applicable
Name;
Address:
City: State:
ZIP: Phone: —
BONDING COMPANY:
Name: _
Address:
City:
Zip: Phone:
—Not Applicable
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 Count yy makes no representation that is granting a permit will authorize the permit holder to build. thesublect structure
which is in contlictwith 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 ail 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 berecorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
comrnencinR work or recording our Notice of Commencement.
Signature of Owner/ Agen / essee Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORIDA.
COUNTY OF eroward COUNTY OF
The forgoing instrument was acknowledged before me I The forgoing instrument was acknowledged before me
this _ day of 200 by this _ day of 20=1by
Scott Harala
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
DENISE BROWN
.Commission 4(66d"0607
Expires November 4, 2018
coMed Tivu Tlov Fea Inswaxo 806-25.7010
Scott Harala
(Name of person acknowledging)
(Signature of. Notary Pub —State of Florida)
Personally Known x OR Produced identification
Type of Identification Produced
Commission No.
ISE
commission # FF 140607
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