HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONa
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: oZ • ���
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Building Permit Application ®EC 0 2017
Planning and Development Services PER10ITTING
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: Siding
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Address: 15200 ORANGE AV EXT
Legal Description: 7 35 39 W 1/2 OF SW 114 OF NW 1/4-LESS N 985 FT AND LESS W 46 FTAND LESS RD AS IN PB 22-16- (4.76 AC) (OR 1877-700)
Property Tax ID #: 2307-233-0010-000-7
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Install house wrap for dry in. Install Hardie plank and window- door trim
E1HVAC
Electric Plumbing ❑Sprinklers Roof
Total Sq. Ft of Construyction�500 Sq.
of First Floor: 1st
Cost of Construction: S-2"TM qP? Utilities: LJ Sewer Septic Building Height: 8-10'
"Shutters
Generator
Lot No.
Block No.
QWindows/Doors
Roof pitch
,16
(C\ ��1M4 "/1�.. YF4 bI 1�i9' R' '# $ ✓- a'F^
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Name James A Maydock Brenda J Maydock
Name: Dave Browne
Address:1043 SW Benchor Ave
Company: Dave Browne's Home Improvments
Address: 5501 Seagrape Dr
City: Port St Lucie State: FL
Zip Code: 34985 Fax:
City: FP State: FL
Phone No.702-241-6631
Zip Code: 34983 Fax:
Phone No. 772-353-0140
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail: 634983@gmaii.com
from the Owner listed above)
State or County License: CRC1330776
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name: James A Maydock Brenda J Maydock
Address: 15200 ORANGE AV EXT
City: Pert & Lucie State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name: Dave Browne
Address: 1043 SW BenchorAve
City: FP State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY:
Name:
Address:55o1 Sea9rape Dr
Citv:
Zip: Phone:
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 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 recording your Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF *S .
COUNTY OF
The forgoing instru ent was acknowledged before me
The f rgoing instr ent was acknowledge before me
this % day of 2n by
this day of 20_1 by
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification '�
Type of Identification
Produced k 1` k&k'*
Produced
( ign ure _f Notary Public- StateO Florida)
(Signs re of Notary Public- Stat Florida )
Commission No.. ,\\II1111,, LASHA(MipGRAM
Notary Public - State of Florida
Commission Nn!.,
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Rev. 8/2/17