HomeMy WebLinkAboutappII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q Qf ' 0 r2j4
Date: �' ���� Permit Number:
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- Building Permit Applicati®n
JUL ®s 2019
Planning and Development Services Permitting Departrpgnt
Building and Code Regulation Division St. Luc;e County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE:
PROPOSED IM�PROVEMENTIOCA' ION;
'Address: 5009 Paleo Pines Circle, Fort Pierce, Florida 34951
property Tax ID #: 1312-801-0141-000-0 Lot No. 338
Site Plan Name: Block No.
project Name:
DETAILED DESCRIPTIMOF WORK:'
Replace w doors with impact and alter one'aopening.pe-l
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CONSTRUCTION INFORMATION ,
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: 1,916
Cost of Construction: $ 10,250 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE _ %. _ - ,
CONTRACTOR:
Name Dietrich, Regina
Name: Ronald Kromhout
Address: 5009 Paleo Pines Circle
Company: Ronald Kromhout General Contractor, Inc.
City: Fort Pierce State:
Address: 4500 5th PI. SW
Zip Code: 34951 Fax:
City: Vero Beach State: FL
Phone No.772-501-4075
Zip Code: 32968 Fax: 772-217-2694
E-Mail: tomandgina54@gmail.com
Phone No 772-473-4597
Fill in fee simple Title Holder on next page (if different
E-Mail kromhoutron@gmail.com
from the Owner listed above)
State or County License CGC 023856
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIER LAW INFORMATION
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name' Edward Roske Seaside Engineers
Name:
Address: 4265 soth Ct.
Address:
City: State:
City: Vero Beach State: FL
Zip: 32967 Phone 772-202-8008
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ^ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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.
Iln consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
iin accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exemptfrom 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
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Signature of Owner/ Lessee/Contractor as Agent for' Owner
Signature of Contractor/License Holder
STATE OF FLORIDA c,
STATE OF FLORIDA
COUNTY OF
COUNTY OF indianwyer
The fffm going instr ent was acknowledged efore me
day by
The forgoing instrument was acknowledged before me
19� day June by
this of 20
this of 20_
Ronald Kromhout
Name of person making statement.
Name of person making statement.
\
Personally Known OR Produced identification
Personally Known x OR Produced Identifi
Type of Identification
Type of Identification.
.
Produced
Produced
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(Signature of Notary Public- Stbte of Florida)
(Signature of Notary Public- State of Florida)
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Commission No. (Seal)
Commission No. f �� 1 �6t0 (Sea
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19