HomeMy WebLinkAboutBUILDING PERMIT APPLICATION6=1
ALL APPLICABLE INFO MUST BE COMPLETED
Date: �TJ 0 ) T
APPLICATION TO BE ACCEPTED
Permit Number: i so, 033 V
Appli
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: Building I ucie County, F�
rT
PROPOSED IMPROVEMENT LOCATION:
Address: L-' 0 R010 K 1? iyr- , 'PSL� j
Legal Description: SABAL CREEK -PHASE I- LOT 9 (4.42AC) (OR 4004-786)
Property Tax ID #: 3321-501-0009-000/6
Site Plan Name: MAHFOOD RESIDENCE
Project Name: MAHFOOD RESIDENCE
Setbacks Front.J-r' 'Dl 1 a3;a k:,,P�
Right Side: Left Side: a
DETAILED DESCRIPTION OF WORK:' p, ,
Lot No.9
Block No.
CONSTRUCTION INFORMATION:
'�
Additional work to e�jje orme under tispermit—checka
10HVAC r✓ Gas Piping
apply:
Li Shutters
a Windows/Doors
LJ Gas Tank
EElectric 0 Plumbing
U Sprinklers
9 Generator
Ri Roof 2 Roof pitch
Total Sq. Ft of Construction: 5859
S , Ft, of First Floor: J859
Cost of Construction: S. 250,000.00
Utilities: Sewer Septic
I
Building Height: 22 ft
OWNER/LESSEE: !
CONTRACTOR:
Name J PAUL MAHFOOD
Name: J PAUL MAHFOOD:
Address: 2807 BENT PINE DRIVE
Company:
City: FORT PIERCE State: FL
Address:
Zip Code: 34951 Fax: 772-879-2208
Fity: State:
Phone No. 770-241-5488
Zip Code: Fax:
E-Mail: ru4genesisl@msn.com
Phone No.
Fill in fee simple Title Holder on next page (if different
EI Mail:
from the Owner listed above)
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of commencement is regwrea.
;SUPPLEMENTAL CONSTRUCTION LIEN LAW, INFORMATION:
DESIGN E�RI GI EER: _ Not Applicable-
MORTGAGE COMPANY: Not Applicable
Name: tj 1A1C
Name:
Address: �
Address:
City: State',:
City: State:
Zip: Phone —
Zip: Phone:
i
FEE SIMPLE Tit' I R: _ Not App icable
BONDING COMPANY: iNot Applicable
Name:
Name:
Address: I
Address:
City: I
City:
Zip: Phone:
Zip: Phone: I
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OWNER/ CONTRACTOR AFFIDVIT: Application iIs 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 perm t, 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 prop Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. f you ntend to obtain financing, consult with lender or an attorney before
commencingwork or recor in ur Notice of Commencement.
I
Signature of Owner/ Lesse n'c1tor as Agent for Ow er
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF �uc:
COUNTY OF
The forWing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this IG day of rkrctq 120 /3 by
this day of 20_ by
-Tarn Imo►"1 Mc..hgVC)
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced6ot-
Produced
Si nature of Nota Pu c� F(Signature
ry
of Notary PublicState of Florida(g
=State
Commission No. 1
I
I
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOIR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
I
DATE
1
COMPLETED
Rev. 8/2/17