HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Datl : 10/25/18 Permit Number: ®ngr1
SCANNED
Building Permit Application BY
ing and Development Services 5t Lucie county
ng and Code Regulation Division
Virginia Avenue, Fort Pierce FL 34982
e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Y
PERMIT APPLICATION FOR: Concrete
;PROPOSED IMPROVEMENT LOCATION:
Address:
4380 INDRIO RD., FORT PIERCE, FL
Legal
Description: 18 34 40 W 150 FT OF SE 1/4 OF SW 1/4 OF SE 1/4 OF NE 1/4-LESS S 40 FT- (1.01 AC)
(OR
1414-1771)
Property
Site Plan
Projei
Setb
Tax ID #: 1418-143-0035-000-0 Lot No.
Name: Block No.
Name: KRULISKY RESIDENCE SLAB . -
i cks, Front 175' Back: 73' Right Side: 38' Left Side: 55'
IDETAILED
DESCRIPTION OF WORK:
NEW CONCRETE
SLAB FOR PORCH
J
CONSTRUCTION
INFORMATION:
Additional
E]HVAC
work to e ertormed
Electric 0
under tispermit—check, a
Gas Tank Gas Piping
Plumbing Sprinklers .
apply:
❑Windows/Doors
Generator E] Roof Roof pitch
_Shutters
1-1
Total ISq. Ft of Construction: 464 SF
Cost of Construction: $ 4,900.00
S . Ft. of First Floor: N/A
Utilities: Sewer ElSeptic
Building Height: N/A
OWNER/LESSEE:
CONTRACTOR:
'�
Name u �,, �"' "
Name: PAUL KUHN
Address: ' 41-3 Rd
Company: HERITAGE CONTRACTING SERVICES, INC
City: i�. PrN�'Ce., State: FL
Address: 3690 N US Hwy 1
FORT
Ci FORT PIERCE' ';'' State: FL
City:,'
Zip Cl de: sN9 Sf Fax:
Phone No. 77� � � �.�".���
:>34946.,,, ,..ti` , . N/A ' -
Zip Code. Fax:
Phone No. 772-216-6612.
E-Mail:
fee simple Title Holder on next page (if different
Fill in
E-Mail: PAUL.K.HCS@GMAIL.COM
from
the Owner listed above)
State or County License: FLCGC1507158
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN .LAW FNFORMATION;
DESIGNER/ENGINEER: X Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:3690 N US HWY 1
City:
Zip: Phone:
MORTGAGE COMPANY: Y% Not Applicable
Name: /
Address:
City: State:
Zip: Phone:
BONDING COMPANY: 'IVot Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is 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 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 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 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
commenciniz work or recordirm vour Notice of Commencement.
A 6ae,
Signature of Owner/ Lessee/,Contractor as Agent for Owner
Signature '—Fr— - '—Aicense Holder
STATE OF FLORIDA C�
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing nstru nt as acknowledged before me
i
The forgoing instrumew was acknowled before me
by
this.M day of 201L by
this day of 20
Name of person making statement
Name of person making statement
Personally Known_OR Produced Identification
Personally Know✓\ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
i
I
ignature of Notary Public- Sta f Florida)
(Signs ure of Notary :u6lic- State o4jorida )
Commission No.
Commission N L)NA INGRAM
LASHAHNA INGRAM
�,JXY �U,�•, Public - State of Florida
tiPa�pve�.,
o ..
a . . o ; Notary Public •State of Flonda
=�#µv
Notary
" ' •ie My Comm. Expires Dec 20,
2018
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Rev.8/2/17 1 V 1