HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Q LaA' I �] Permit Number:
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Building Permit Application QEu 2 1 2u,l7
Planning and Development Services
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: Building
PROPOSED IMPROVEMENT LOCATION:
3054 NW RADCLIFFE WAY
Address: •�� ��r�� � �� l • li � �
Legal Description: RIVERBEND (PB 67 36) LOT 15
Property Tax ID #: 4425-703-0020-000-1 Lot No.15
Site Plan Name: Block No.
Project Name:
Setbacks Front41.10' Back: 206.63' Right Side: 18' Left Side: 18'
DETAILED DESCRIPTION OF WORK: ,
SINGLE FAMILY RESIDENCE 2�STORY09-BEDROOMS,09"MB'ATHS, 3 GARAGE
'CONSTRLICTION IN.FORMATION:...
Additional work
. to be pertormed under this permit— check all apply:
RjHVAC 0 Gas Tank ❑Gas Piping _ Shutters ✓Q Windows/Doors
RjElectric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Constructioffl[UR7AV S . Ft. of First Floor: 2974 2ND FLOOR 1565
Cost of Construction: $ 516800.00 Utilities: Sewer Septic Building Height. 27'•6°
OWNER/LESSEE:
CONTRACTOR:
Name Standard Pacific Of Florida
Name: SCOTT HARALA
Address:15360 Barranca PKWY
Company: STANDARD PACIFIC GROUP OF FLORIDA
City. IRVINE State: CA
Address: 825 CORAL RIDGE DRIVE
Zip Code: 92618 Fax:
City: CORAL SPRINGS State: FL
Phone No.954-575-7355
Zip Code: 33071 Fax:
E-Mail:
Phone No.
Fill in fee simple Title Holder on next page ( if different
E-Mail: PWXLISA@YAHOO.COM
from the Owner listed above)
State or County License: CGC 1506052
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW fNFORIVIATION '
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ NotApplicable
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:
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 contiict 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
commencinlp, work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA-
.{
COUNTY OFT (bt
The forgoing instrument was acknowledged before me
this 19 day of December . 2017 by
Name of per on making statement
Personally Known 41. OR Produced Identification
Type of Identification
Produced
(Signature of Notary - State of Florida )
.1►%1Y 140
Commission No. ;:4' SIVD��IeIACHAR
Y COMMISSION # GG08291 4
EXPIRES April 10, 2021
Signature of Contractor/License Holder
STATE OF FLORID,�a
COUNTY--
�'�-'c
The forggoing instrument was acknowledged before me
this 19 day of December , 20 17 by
(` 1 Iy.
Name of person making statement
Personally Known A_ OR Produced Identification
Type of Identification
Produced
(Signature of Nota y wC'State-e€ �lorlda ),
o'�;A qcei: SIVAN SMar_r�'�
Commission No.
EXPIRES April 10. 2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED ( !
DATE
COMPLETED
Rev. 8/2/17