HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
te:_ Permit Number:
RECEIVED
Building Permit Application SEP 18 M8
Planning and Development Services
Bu�'Iding and Code Regulation Division ST. Lucie County, Permitting
23190 Virginia Avenue, Fort Pierce FL 34982
Plj'�one: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
I
PE MIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PR r, POSED IMPROVEMENT LOCATION:
Address: 4610 Magnolia Dr, Ft Pierce, FL. 34982
Legzl Description:�e
Property Tax ID #:
I'I
Site Plan Name: _
Project Name:
Front loll Back: Right Side: Left Side:
4lLED DESCRIPTION OF WORK:
C
ri
Lot No._
Block No.
COO,,STRUCTION
INFORMATION:
u
AddIponal work to be performed
❑HVAC
under this permit —check
Gas Tank ❑Gas Piping
a
apply:
Shutters
Windows/Doors
_
11Electric ❑_ Plumbing
[]Sprinklers
Generator
Roof Roof pitch
Total
q 117sf
Ft of Construction:
S
Ft. of First Floor:
Cost If Construction: $ 2,450.00
[I
Utilities:lnSewer
❑Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Nam&ouglas J Lane
Name: Mark Detlof
Company: Delo Construction Services, LLC.
Addriss:4610 Magnolia Dr
City: �It Pierce State: FL
Zip C',de: 34982 Fax:
Phon No. (772) 359-8547
Address: 2189 SE Erwin Rd
City: Port St Lucie State: FL
Zip Code: 34952 Fax:
Phone No. (772) 323-9981
E-Mail: mark@deloconstruction.com
E-Ma
l:
Fill in
from the
lee simple Title Holder on next page ( if different
Owner listed above)
II
State or County License: Florida CBC1260244
If valuelof construction is $2500 or more, a RECORDED Notice of Commencement is required.
S
{PPLEMENTALrCONSTRUCTION°LIEN LAW'INFORMATION:
DE
IGNERENGINEER: 1' Nqt Applicable
MORTGAGE COMPANY: Not Applicable
Na°
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Name:
Ad'
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Address:
city:
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City: State:
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Zip: Phone:
FEE
SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
Cit
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City:
Phone:
Zip: Phone:
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OW ER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I ce Tify that no work or installation has commenced prior to the issuance of a permit.
St. L�cie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
whic� 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 co'', `sideration 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 Building Codes and St. Lucie County Amendments.
The Allowing building permit applications are exempt from undergoing a full concurrency review: room additions,
acce Isory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WA i NING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
imp ;ovements to your property. A Notice of Commencement must be recorded and posted on the jobsite
bef re the first inspection. If you intend to obtain financing, consult with len er or an attorney before
co encing work�ecording vour Notice of Commencement.
Sig atur6 of Owner/ LeContractor as Agent for Owner
ST TE OF FLOW
Th ;forgoing instrument v4as acknowledged before me
ti ! 6 day of 20 by
Name of person making statement �_—
Pe `sonally Known OR Produced Iden f'
Ty `e of Iden ' 'cation
Pr duced
® s e
itc-State-Of FlcErigK ember 22, 2018 a
Seal�' FF 162257 �.
Signature of Contractor/Licenc*Holder
STATE OF FLORIDA
COUNTY OF
The foToing instrument was acknowledge before me
this 0 day of v y20a by
Name of person making statement
'Personally Known OR Produced Identification _
Type of Identification
Produced lic1P/S fit`' S�
am
Signature of Notary Public- State of Florida)
�Z ('� 14b101NO
;Commission No. p f 0101
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Rev. /2/17
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