HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED L
Date11j ate+ �d Permit, Number:
SCAN ED ���7� RECEIVED
e� •:�. ��w-- —° �n__�-�l�i w _ _ 1.� n i it o o ?nia
Plan��Ing
Building
2300
Pho"'I
i
and Development Services ST. Lucie County, Permitting
and Code Regulation Division
Virginia Avenue, Fort Pierce FL 34982
: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Le!f—
PERMIT
APPLICATION FOR: Building 0
PRO,,OSED
IMPROVEMENT LOCATION:
Legal Description:
2
DRAWDY/BROCKSMITH ROAD SUBDIVISION PB 75-3 .-,
( ) LOT 6501 AC SF)
)
Prope
y Tax ID #: 2329-502-0006-000-9 Lot No.
'
Site Plan
Project
Name: Block No.
Name:
Setbaj
s Front 121' Back: 738.22 Right Side: 40' Left Side: 141.40'
DET
'AILED DESCRIPTION OF WORK:
Construct
i�
aL412/2 Single Family Residence
�i
CON 'TTRUCTION INFORMATION:
Additional work to be performednerformed under this permit —check a -apply:
„IVAC Ll Gas Tank ❑Gas Pi
ectric ❑�_ Plumbing []Sprint
Total S' . Ft of Construction: 3293
Cost ofConstruction: $ Z°53, 5cc1
ng UShutters [- Windows/Doors
ors Generator RI Roof Roof pitch
S Ft. of First Floor: 3293
Utilities:MSewer R1 Septic Building Height: la-'�w•
OWN',ER/LESSEE:
CONTRACTOR:
Name
Addres
City:
Zip Cok
Phone ''l
E=Mailt�l
Fill in fete
from t
Name: Ubtg 1i. Cr�za
: 3APS Aire, Dr.
Company: Groza Builders,lnc.
"W, PiBrG2 State:FL
34981 Fax:
o. -112 ^ 2—(0-1
Address: SII Sub Poor+Sa-, Lucie Puri -
City: for+ S+. Lur_if. State: FL
Zip Code: 34953 Fax:
Phone No. 7723367653
ON
simple Title Holder on next page ( if different
II Owner listed above)
E-Mail: Tony@grozabuilders.com
State or County License: CGC1524734
If value Of construction is $2500 or more; a RECORDED Notice of Commencement is required.
SUP,rLEMENTAL
CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Narrli2:
Address:
City..
Zip:
III
_ Not Applicable
a 6,c-6pkt-11' D
MORTGAGE COMPANY: _ Not Applicable
Name:
1oc(o V(4L'60"r Dro'" IN-,
Address:
'IQavoka. ("V &0- State: FL.
33q 93 Phone qqJ-U?_?_ Dc,35
City: State:
Zip: Phone:
FEE
Nam
Addi`��
City;
Zip:
Il
IMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
ss:
Address:
I�
City:
Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certil that no work or installation has commenced prior to the issuance of a permit.
St. LuciCounty makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which Iin conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structu ie. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In cons eration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acccl idance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fol owing 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
WAR ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improl" ements 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
com encin work or recordingour Notice of Commencement.
Diu'
i
Sig Lure
of Owner/ Lessee/ ntractor as Agent for Owner
Si ature of Contractor/Li se Holder
STA
E OF FLORIDA
STATE OF FLORIDA
COU
i�
TY OF S'i-L'W1i'
COUNTY OF St, L_uGie.
The f�o�r�g�ing
instrument was acknowledged before me
The for ing instrument was acknowledged before me
day 20A by
thisrx"
day of of 20/f by
this of ar
11LIZho
D L �Oz�
` ohm fi iAoaq `7roza_
Name of person making tement
Name of person king sta ent
Pers
ally Known /� OR Produced Identification
Personally Known OR Produced Identification
Type;
5f Identification
Type of Identification
ProdLIced
I
Produced
( ign
Iture Notary P i Late f FINLEY
(Signatuof Notary Pu
Y OMMISSION # FF936804
•`'�' ANGIE FINLEY
:.? �L
Com
ission No. (
PIRES i 0��mber 17, 2019
Commission No. MY CdOMES1ON # FF936804
4407)3980-53 FloridaNe4lrySeNica.com
"'•,,w���,.•• EXPIRES November 17, 2019
A8.0153
(407) F1oWalloWry99rVice:c0m
REV
EWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE,
RECE,
ED
DATE]
COIVI�,LETED
Rev. 86, /17