HomeMy WebLinkAboutBuilding Permit Application 6-18-17ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / n /� ??
Permit Number: 7o to,
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Building Permit Application '
Planning and Development Services �`� ,�% JUN 2 8 2017
Building and Code Regulation Division C
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2300 Virginia Avenue, Fort Pierce FL 34982 0
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
Date: June 15th , 2017
PERMIT APPLICATION FOR: Building I
Address: 4876 Watersong Way, Fort Pierce, FL 34994—
Legal Description: WATERSONG PUD PLAT NO. ONE (PB 42-34) LOT 50 (OR 3990-2190)
Property Tax ID #: 2532-500-0064-000-1
Site Plan Name: Watersong ,
Project Name: Medina Residence
Setbacks Front 10 Back: 40 Right Side: 6 Left Side: 6
DETAILED DES,CRIP.TION OF WORK `
5
0
Lot No. 50
Block No.
NEW CONSTRUCTION OF A SINGLE FAMILY RESIDENCE; (5)FULL BATHROOMS, (1) 1/2
BATHROOMS, 4 BEDROOMS WITH 2 CAR GARAGE. rV CY l non -
gHVAC 1_,1 Gas Tank
IElectric 0 Plumbing
Total Sq. Ft of Construction: 5719 SF
Cost of Construction: $ 1,100,000
[11s PerrniL — cnecK du dppiy:
]Gas Piping _ Shutters Z Windows/Doors„
Sprinklers []Generator Z Roof 5-12 Roof pitch
S . Ft. of First Floor: 1906 SF
Utilities: 21 Sewer ElSeptic Building Height: 31'-5"
AWNER%LESSEE ,,. �
CONTRACTOR ';� 1
Name Raul Medina
Name: Mario Arbucci
Address: 6350 SW 92nd ST
Company: Coastal Construction and Design, Inc.
City: Pinecrest State: FL
Address: 1812 NW Old Oak Terr.
Zip Code: 33156 Fax:
City: Jensen Beach State: FL
Phone No. 305 625-4601
Zip Code: 34957 Fax:
E-Mail: medinajrr@comcast.net
Phone No. 772.260-7514
Fill in fee simple Title Holder on next page ( if different
E-Mail: marbucci@comcast.net
from the Owner listed above)
State or County License: CRC013539
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name: James Bushouse PE
Name:
Address: 1550 N. Mdrews Ave.
Address:
City: Pompano Beach State: FL
City: State:
Zip: 33059 1 Ph One: 954956-2203
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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 / an attorney before
commencing work or reco-rdine vour Notice of Commencement. A .1.1
Signature
as Agent
STATE OF COUNTY OF FLORIDA „�/ ( �� I COUNTY OF STATE OF FLORIDA RAfi ,-GA/
The f ing instr s acknowledged before me
this day of �k 20 jL1 by
1
(Name of
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(Signatu of N tary ublic-State of Florida)
Personally Known OR ProducVJ Iden ' tion
Type of Identification
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�o.: •. ;�.�; ONTRAN M. DOMINICIS
Commission No. _ :: MY C0"WON # GG 104216
s, ."V EXPIRES: September 11, 2021
%FoF ;:• Bonded Thru Notary Public Underwriters
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this 2) day of V V /L/ ,tom _ . 20 17 by
acknowledging)
(Signature of Nota'r Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. ��e� (Seal)
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