HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APIPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �
II' �� —1 Permit Number:
Date: li SCANNEE)
_fig BY
• , °jam S�,1,' Cie cOun'% � f
lr/
- Building Permit Application
Plann,ng and Development Services
Bwldi g and Code Regulation Division
230011 irginia Avenue, Fort Pierce FL 34982
Phon�L: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PER
Addri
Legal
IT APPLICATION FOR: Building
)SED IMPROVEMENT LOCATION:
: 10701 S OCEAN DRIVE LOT 697, JENSEN BEACH, FL 34957
ption: VENTURE OUT -SECTION C- LOT 98 (OR 3280-2348)
Propeii yTax ID #: 4511-805-0098-000-5
Site P an Name:
Proiect Name:
ks Front 10'-0" Back: 5'-0" Right Side: 6 INCH Left Side: 8'-0"
DETAILED DESCRIPTION OF WORK:
BUILD NEW TWO STORY CBS HOME
1),1' -
Lot No.
Block No.
I CONSTRUCTION INFORMATION: I
Aaaiitionai worK to bje nertormeci under this permit— check all apply:
ZHVAC L_f Gas Tank ❑Gas Piping _Shutters a Windows/Doors
1 Electric 0 Plumbing Sprinklers Generator Roof
Tota �Sq. FtIof Construction: 1695 S . Ft. of First Floor: 900
Cost of Construction: $ 244,000 Utilities: 136Sewer R Septic Building Height:
�I
O sNER/LESSEE:
CONTRACTOR:
Na"
Addl`less:
" EDWIN D & LESLEY A CEHELNIK
Name: MACK MATOS
Company: MEL-RY CONSTRUCTION
Address: 10967 S OCEAN DRIVE
�;Q 9)2111 W Roc-cl
City)A CC4 STy %z State: PY4-
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax: 772-229-9440
Phone No. 772-229-9439
Zip li ode:176Ch 1 Fax:
Pho a No. :Z7 .?,
E-Mlail:
E-Mail: MACK@MEL-RY.COM
State or County License: 23630
Fill Jn fee simple Title Holder on next page (if different
fro II the Owner listed above)
l�
it value of construction is 5Z500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL
CONSTRICTION LIEN LAIN INFORMATION.:
DESK{{NER/ENGINEER:
Nam
-Add r
City:TUART
Zip: 3
_ Not Applicable
I: JOHN CRESWELL PE#27002
MORTGAGE COMPANY: _ Not Applicable
Name:
Address;
City: State:
Zip: Phone:
I+SS: 4459 SE KUBIN AVE
. State: FL
997 Phone: 772-21"156
I1
FEE S
Nam
Addr.
City:
Zip:
MPLE TITLE HOLDER: _ Not Applicable.
F
BONDING COMPANY: Not Applicable
Name:
. ss:
Address:
City:
I
I Phone:
I1
Zip: Phone:
that no work or installation has commenced prior to the issuance of a permit.
St. Luc a County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
struct j e. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In con Iideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accc 'rdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fo owing building permit applications are exempt from undergoing a full concurrency review: room additions,
accessi. ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR PING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impr Vements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befor' the first inspection. If you intend to obtain financing, consult with lender or an attorney before
com encing work or recording vour Notice of Commencement.
s
sign 11 ure of Owner/ Lessee/Agent Signature of Contractor/License Holder
STAT OF FLORID�1.i STATE OF FLOf�,IDA
COUNTY OF 4DI ��%� COUNTY OF ,I�l�-
The f ,Irgoing instrument was acknowledged before me
this ii day of /o2ol-S—by
(Nam �of per n acknowledging )
(Signature of Notary Public -State of Florida )
rsor fall A43,jU®&OW Mmmirific ion
Typeo Ide itProd digs a6 Matos
{I < My Commission EE32
I� Expires 10/12/2016
Comm ssio o.°"` _ . _ _ _ l
Reviled 07/15/2014
The forgo: instrument was acknowledged before me
this � day of &t4 20 45� by
/'j'ke-A' #?r4 To S
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known _ OR Produced Identification
Type of Identification Producgo_ L,. ,
Commission A, ° ; • �/ J�ITHLEEN C.€RS
Notary Public - $ Mate /Florlda-
My Comm. Expires Dec 19, 2017
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