HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
�LICABLE INFO MUST BL %.%jMPLETED FOR APPLICATION TO BE ACCErYtD
Permit Number:
RECEIVED
Building Permit Application MAR 09 1010
Planning and DevelopmentServices Permitting Department
Building and Code Regulation Division St. 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
PROPQSED I PRQI/EMITLQCAT
Address: 138 Commonwealth Ct Ft Pierce, FI 34949
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Legal Description: Queens Cove - Unit 1 BLK 14 Lot (or 874-2565)
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Property Tax ID #: 1414-701-0132-000-0 I
Lot No. L(or874-2565)
Site Plan Name: n/a
Block No. 14
Project Name: n/a
Setbacks Front Back: Right
Side: Left Side:
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Additional work to be nertormed under this permit —lc ec a apply:
11HVAC 11Gas Tank Gas Piping Shutters a Windows/Doors
_
11 Electric ❑ Plumbing Sprinklers FIGenerator W1 Roof 5�12 Roof pitch
Total Sq. Ft of Construction: 3,200 S Ft. of First Floor:
Cost of Construction: $ 27,300 Utilities:n Sewer Septic Building Height:
"KF { '/as55� „y'E 3` $7
RJ sS,
25. 3y
CQNTRACTQ� f s
Name Don and Barbara Donaldson
Name: William Lasky Jr. ,
Address: 138 Commonwealth Ct !
Company: Atlantic Roofing II of Vero Beach Inc.
City: Ft Pierce, State: FI
Address: 4020 43rd Ave
City: Vero Beach State: Fl
Zip Code: 34949 Fax:
Phone No. i
Zip Code: 32960 Fax: 772-257-5740
E-Mail:
Phone No. 772-492-8493
E-Mail: wljatr@aol.com
Fill in fee simple Title Holder on next page ( if different.
from the Owner listed above)
State or County License: CCC1326188
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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i� M N, A'L CC7N5 IC N I.I I:A 11t INFORNIAII{
N` t y ;' ,
,
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
N am e : Don and Barbara Donaldson
Name: William Lasky Jr.
Address: 138 Commonwealth Ct Ft Pierce, FI 34949 I
Address: 138 Commonwealth Ct
City: Vero Beach
State:
City: Ft Pierce, State:
Zip: Phone
I
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address:
Add ress: 4020 43rd Ave
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.
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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 yoyqntend to obtaip financing, consult with lender or an attor before
commencing work or recordi our lotice of Commencement.
Signature of Owner/ Lessee%Contracty
asVAgent for Owner Signature of Contractor/License Hol
STATE OF FLORIDA �1 �% STATE OF FLORID "
COUNTY OF � 1 m cl., '` au COUNTY OF l .�1,')�)c�v�4,)
The for ng instru nt was acknowledged before me
this way of C 20_a by
Name of person making statement
Personally Known (/ OR Produced Identification
Type of Identification
Produced
LA]
(Si&,LtyA of Notary
Public- State of Florida )
Commission No. �f1O 5 & 15 (Seal)
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
Rev.B/2/17
ZONING SUPEF
REVIEW REVI
DEBORAH L. AUSTIN
Commission # GG 165615
Expires January 6, 2022
Bonded Thru Troy Fain Insurance
The fo oing instrumQtt was acknowledged before me
this _ day of 20�1P by
Name of perso aking sta ement
Personally Known OR Produced Identification
Type of Identification
Produced
r
(SihiaOre of Notary Public- State of Florida )
Commission No. 665 16 561 (Seal)
R PLANS I VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
DEBORAH L.AU TIN
Expires January 6, 2022
9onded Thru Ttay Fain insurance 8*385.7019