HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : 11-3-2018 Perm it'Number:
RECEIVED
Building Permit Application Nov 0 8. 2010
ing and Development Services Permitting Department
ng and Code Regulation Division St. Lucie County
Virginia Avenue, Fort Pierce FL 34982
e: (772) 462-1553 Fax: (772) 44624578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line SCANNEI
IMPROVEMENT LOCATION:
Address: 610 Willows Ave Port Saint Lucie, FL M Y2) 1 ' /, 1
Legal Description: RIVER PARK -UNIT 2- BLK 19 LOT 12(MAP 34/22N) (OR 3644-2153)
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Property Tax ID #: 3419-510-0243-000-6 Lot No.12
Site Plan Name: Block No. 19
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Project Name:
Setbacks Front25.50' Back: 82.25' Right Side: 12.38' Left Side: 11.91,
f DET41LED DESCRIPTION OF WORK: ,
New Constructed CBS 31212
CONSTRUCTION INFORMATION:
Add
itiona wor to e e orme under this permit —check a app y:
�HI VAC Gas Tank []Gas Piping _ Shutters ✓� Windows/Doors
Electric 0 Plumbing Sprinklers Generator F171 Roof ® Roof pitch
Total Sq. Ft of Construction: 2031 Scl. Ft. of First Floor: 2031
Cost of Construction: $ 6161AY3 Utilities:0Sewer L6Septic Building Height: 17'
OWNER/LESSEE:
CONTRACTOR:
Name Claire & Kevin O'Connor
Name: Philip Petruzellie
Addressl:332 Holly Ave
Company: Port Saint Lucie Properties, INC
City: Port St. Lucie State:fl
Address: 2401 SW Monterrey Lane
Zip Code: 34952 Fax:
City: Port Saint Lucie State: FL
Phone No.772-249-0089
Zip Code: 34953 Fax:
E-Mail:
Phone No. 772-249-0086
Fill in fee simple Title Holder on next page ( if different
E-Mail: psiprop1224@gmail.com
from the Owner listed above)
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State or County License: CBC 1257923
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ____ Not Applicable
MORTGAGE COMPANY:_V Not Applicable
Name: Paul welch Inc
Name:
Address:
Address:1984 SW Biltmore Blvd
City: Port Saint Lucie State: Fl
City: State:
Zip: 34984 Phone772-785-9888
Zip: Phone:
FEE ISIMPLE TITLE HOLDER: — of Applicable
BONDING COMPANY: ' Not Applicable
Name:
Name:
Add ress:2401 SW Monterrey Lane
City:
Zip: Phone:
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
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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
ommencl orK r recoraing your Notice or commencement
it
Si a'ture of Owner/ L s /Contractor as Agent for Owner
Signa ure of Contractor c nse Holder
STATE OF FLORID
COUNTY OF _�d._L�
-k
STATE OF FLORI A
COUNTY OF �9--. L()L;-e-
The forgoing instrument was acknowledged before me
this 3fd day of November , 20JR by
The forgoing instrument was acknowledgeq before me
this 3rd day of November 20_0 by
Philip Petruzellie
Name of person making statement
Name of person making statement
Personally Known x OR
Type of Identification
Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Produced
Produced
(Sig ture of Notary Public-
W.Of rineirin I
Sig ature of Notary Public- State of Florida )
<y;4; MICHELLE LOBRUTTO
z' :_ (fission # FF 949733
-
Expires January 12, 2020
Bonded ThruTroy Fain Insurance 800J85.70
Commission No.
py;., MICHEgTelllp LITTO
ommission No. e• ,•,
=�: k Commission # FF 949733
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i�i, Q.° Expires January 12, 2020
9 7f FAQ•• BondedT
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Rev. 8/2/17