HomeMy WebLinkAboutBUILDING PERMIT APPLICATION11
ALL APPLICABLE INFO MUST BE COMPLETED
Date: y 1gl 1'
Buill'a
APPLICATION TO BE ACCEPTED a
Permit Number:
kNNED
V
t Applicati
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: Buildingl
RECEIVED
APR 2 6 2018
ST. Lucie Court P rml_Ing
esid— ti
PROPOSED IMPROVEMENT LOCATION,:
Address: % �1I � I "I
22 35 38 NE 1 /4 OF NW 1 /4-LE S N43.5 FT (38.88 AC) (OR 4031-304)
Legal Description: 1
Property Tax ID #: 2222-211-0001-000-3'
Site Plan Name:
Project Name: Baxley Residence I
Setbacks Fro[#L ' " " Back• . .1 0 \ Right Sid
Left Side:
DETAILED DESCRIPTION OF WORK: '
Lot No.
Block No.
Construct a new single family home with 4 bedrooms, 3 bathrooms, and 3 car garage. - - V
CONSTRUCTION INFORMATION;`.
Additional work to be nertormed under t is permit — check a apply:
ZHVAC Gas Tank Gas Piping _ Shutters Windows/Doors
' 5/12
Electric Plumbing zSprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 4004 S . Ft. of First Floor: 4004
Cost of Construction: $ 152,152.00 I Utilities:Sewer Septic Building Height: 22'
I
OWNER/LESSEE: CONTRACTOR:
Name u e Saxley Name: Kyan Davis
Address:5810 NW Argo Ct Company: Synergy Homes,
LLG
City: Port St Lucie I State: _ Address: 1610 Yarmouth Ave
Zip Code: 3 `19 6' (o Fax: I City: We Ing on State
Phone No. I Zip Code: 34953 Fax:
canine ara gmal.com - -
E-Mail: I Phone No.
Fill in fee simple Title Holder on next page ( if different E-Mail: Justin CaPsynergyhomesti.com
from the Owner listed above) i State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
. , a.
DESIGNER/ENGINEER: Not Appliable.
Name: Lillian n_ Gonzalez, RE. —Name:
Addr.�$S uqul t. I
City. W • _ _ St�te:I
MORTGAGE CQJVIPANY: Not Applicable
Harbor Community Bank
Address:1+009 Okeechobee Rd
City: rt State:
Zip: Phone 2 I
_ _
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: Luke Baxley —
BONDING COMPANY: x Not Applicable
Name:
Add rss: I
City.
Address:
city:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Applicationl 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 B ilding Codes and St. Lucie County Amendments.
The following building permit applications are exem t 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
commencingwork or recording your.Notice' of Commencement.
h
S' ature rofer/ Lessee/Contractor as Agent f rOwner
ignature of Contractor/License Holder
STATE RIDA
STATE OF FLORIDA
COUNTY OF Sk- I I Ch--C.
COUNTY OF - I L)c I-Q
The forgoing instrument was acknowledged befo a me.
The forgoing instrument was. acknowledged before me
Z�K't,
thisay of I)Pl, , 20 kS by
this +kay of N r-LL 20ff by
Name of perso}�' making statement I
Name of person aking statement
Personally Known �/ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature N - F
(Signature of N r blic- State of Florida
Commission No. _ MALLORY KOCHERSP
�
�Pu
Commission aCp !- MALLORY KOCHERSPERGE )
al
SIGN# G
EXPIRES: March 29, 2022
7
MY COM N # GG2018 4
°y+2,��°�° EXPIRES: March 29, 2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
'VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
I�
DATE
COMPLETED
tev_ 9/2/17
I w