HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR / APPLICATION TO BE ACCEPTED
� Number.
Date: ." "V'-JW / �J Permit
Vale,
�� 'SCANNED' RECEIVED
BY
Building Pe mit pplication MAR 9 6 2018
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division v
2300 Virginia Avenue, Fort Pierce FL 34982 X
Phone: (772) 462-1553 Fax: (772) � 2-1578 Commercial Residential
PERMIT APPLICATION FOR: /To Select from dropbox, click arrow at the end of line
:PROPOSED fMPROVEMEN
Address: 5333 Emerson Ave 3gQ5-/
Legal Description: 10 34 39 S�/2 of N 1/2 of SE 1/4 of SE 1/4-Less W1/2 and N 30 FT and Less Rd and Canal
RS/W-(4.34 AC) (Or 4037-?792)
77
Property Tax ID #: 1310-441-0021-000-3 Lot No.
Site Plan Name: Block No.
Project Name: Brion Pauley
.01
Setbacks Front-'.Cp= -_ oack: Right Side:_ Left Side:
DETAILED DESCRIPTION°OF WORK::
r �.
?iJ e07-M/ 2 IbAT14 Z CAR
CONSTRUO
INFORM,ATION
Additional or to eeneorme under this permit— check a apply:
ZHVA LI Gas Tank ❑Gas Piping Shutters ✓a Windows/Doors
_
/ric
2 Ele 0 Plumbing []Sprinklers F]Generator Roof 5/� 2 Roof pitch
Total S Ft of Construction: 1792 S . Ft. of First Floor: 1792
9 ►I J
Cost qfConstruction: $ I�O,OGV — Utilities: Sewer Septic Building Height: «-1
OWNER/LESSEE
_ _..
'CONTRACTOR:
Name Brion Pauley
Name: Carl A. Lachnitt
5333 Emerson Ave.
Ad/dress:
Company: Cal Builders Inc
City: Ft. Pierce State: FI
Address: 2020 Old Dixie Hwy SE Ste, 6�
Zip Code: 34951 Fax:
City: Vero Beach j
Phone No. '1^12 53$ - &S-(S,
Zip Code: 32962 Fax: J
E-Mail:
Phone No. 772-562-3715
Fill in fee simple Title Holder on next page ( if different
E-Mail: Calbuilderinc@aol.con
from the Owner listed above)
State or County License: S_ ate/
jr vajue or construction is SZ500 or more, a RECORDED Notice of Commencement is required.
r _\
.SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Todd N. Smith, P.E., Inc 1
Name: Harbor Community Bank
Address: 914 20th Place I
Address: 3900 20th street
City: Vero Beach State: FI
City; Vero Beach State: FI
Zip: 3zsso Phone 772-559-3699
1
Zip: 772-234-7858
P� 32960 Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address: 1
Address:
City:
City:
Zip: Phone:
Zip: Phone: I
1
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 co7menced 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.
the of this requested permit, I do hereby agree that I will, in all respects, perform the work
In consideration of granting
in accordance with the approved plans, tI 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, f nces, 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, our Notice of Commencement.
Signa a of Owner/ Lessee/Contractor as Agent for Owner
Signa#ure=o -C-oYi ense Holder
STATE OF FLORIna
STATE OF FLORI A _
COUNTY OF Ctji�
COUNTY OFF �n c
1
The f rgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this � day of Qt.✓C'.I'1 , 20 by
this day of (x� i'1 , 20 by
Brion Pauley I
Carl A. Lachnitt
Name of person making statement
Name of person making statement
Personally Known -76,.-� OR Produced Identification
Personally Known �� OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signat a of Notary Publi ate of Fldi'jrdtNNE COLLINS
=o
MY COMMISSION #FF1 96945
( gnature of Notary P b1RyP9'9ate of P18NII&FOLLINS
<� MY COMMISSION #FF196945
t���IAES: jf�,7a(�2019
Commission No. � E){PIkSea08 24, 2019
Commission No.te
A,
bonded through 1st State Insurance
ceo through st State Insurance
REVIEWS
1
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
�0
DATE
COMPLETED
Rev. 8/2/17