HomeMy WebLinkAboutBUILDING PERMIT APPLICATION` r \
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� SCANNED Permit Number:
BY FIVED
• '� St Lucie County
Building Permit Application 0 2018
Planning and Development Services PerPTtIM
Building and Code Regulation Division S--T. Lucie County,
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR To Select from dropbox, click arrow at the end of line &iV"t'/o
PROPOSED 111tfPROht%EMENT LO:CATIQN
i.M
Address: 7909 Meadowlark Lane, Port St Lucie, FL 34952
Legal Description: The Preserve at Savanna Club BLK 50 Lot 20 (OR 1931-553)
Property Tax ID #: 3425-706-0210-000-6
Site Plan Name: Savanna Club
Project Name: John T and Sylvia G Hallsworth
Setbacks Front 22' Back: NA
Right Side: 7•5' Left Side: NA
Rebuild a 12' x 29' carport with an elite roof destroyed from Hurricane Irma
Lot No. 20
Block No. 50
Additional work to be ertormed under this permit —check all apply:
E1HVAC Ei Gas Tank Gas Piping _Shutters Wirtdows/Doors
❑ Electric ❑ Plumbing ❑ Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: 348 sq ft Sq. Ft. of First Floor:
Cost of Construction: $ 2200.00 Utilities:Sewer 0Septic Building Height: 8' 5"-7'11"
OWNER/LESSEE`
CO R " k
NTRACT,O
3 �
Name John T and Sylvia G Hallsworth
Name: Steve Yetzer
Company: RV Construction
Address: 7909 Meadowlark Lane
City: Port St Lucie State:FL
Address: 3318 Columbrina Cir
City: Port St Lucie State: FL
Zip Code: 34952 Fax:772-340-0522
Phone No. 978-764-9425
Zip Code: 34952 Fax: 772-340-0522
E-Mail: tasha592@verison.net
Phone No. 772-380-8253
Fill in fee simple Title Holder on next page ( if different
E-Mail: steveyetzer@yahoo.com
State or County License: CRC 1330965
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEfVIEIVTAL CONST,RUCTIQN LIEN LAW
INFORMATION:
,gib.,- 4 l g"ALG s. n,�' .• T �i
. _ 4.,.. ... � ....._ n �,,.
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
N a m e: John T and Sylvia G Hallsworth
Name:
Address: 7909 Meadowlark Lane
Address: 7909 Meadowlark Lane, Port St Lucie, FL 34952
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 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 pa 'ng twice for
improvements to our property. A Notice of Commencement must b ecorded and post o the jobsite
before the fir ins ee ction. If you in n len to obtain financing, consu wit der or an at me before
commeftinR work or recordin vo r N tice of Commencement."
Signature o ner/ Lessee/Contra Vs Agent for Owner
Signatur (Contractor/License Hold
STATE OF FLORIDA
OF 3�- `fa
STATE OF FLORID
COUNTY OF 1h
COUNTY p'c�e.
C
The fo�going instrument was acknowledg d before me
this 7f_'t day of .tn 20 by
The for ing instrument was acknowled ed�efore me
this Z day of —7�kfn 20L by
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CJI�
Na a of per s nf�aking statement
Nam of perso paking statement
Personally Known V OR Produced Identification
ersonally Known OR Produced Identification
Type of Identification
Ty a of Identification
Produced
Pry ed
Signs ure of Notary Pub c- State of Florida) �(� ��`' eon°
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ignat a of Notary Pub - State of Florida
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G��. ��Q
Commission No. 03q eal) y Q�Q
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Commission Ntiu�
REVIEWS
FRONT
ZONIN
UPERVISOR
PLANS
VEGETATION
SEA T
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
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RECEIVED
DATE
COMPLETED
Rev. 8/2/17