HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE/INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r
Date :21- 12 Permit Number:
Building Permit Application SCANNED
i and Development Services BY
and Code Regulation Division
St Lucie County
ginia Avenue, Fort Pierce FL 34982
(772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
DDr1Df)C1cn MADDr1VCMFKIT=I hr^'ATir)Ki-
Address: 2503 NW Holiybeny Ln. Palm City, 34990
Legal bescription: Harbour Ridge PLAT NO 1 LOT 17
Property Tax ID #: 4436-601-0017-000-8 Lot No. 17
Site Plan Name: Gianakis Block No.
ProjeI ct Name: Mary Gianakis
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION;OFWORK
Install new Pool enclosure
CONSTRUCTION INFORMATION ;
AU�UILjIUIld1 WUI K LU UC CI IUI IIICU UIIUCI UIM P121IIIIL — L I
L_IHVAC Gas Tank ❑Gas Piping
11 Electric ❑,Plumbing ❑Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ti ILA L 900
Shutters Q Windows/Doors
Generator 11 Roof = Roof pitch
S Ft. of First Floor:
UtilitiesSewer0Septic Building Height:
,OWNER/LESSEE: F
CONTRACTORr �
NalneMaryGianakls
Name: William TDramble
2563 NW Holl a
Address: yb ny Lane
Company: Coastal Aluminum Construction
City: Palm City State: FI
990
Zip Code: 39 Fax:
Phone No,
Address: 496 S. Market Ave.
Ft. Pierce FI
City: State:_
Zip Code: 34982 Fax:
Phone No. 772-468-0288
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: tinman2287@att.net
State or County License:
If Value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: I State:
Zip: I Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address: 496 S. Market Ave.
City:
Address:
City:
Zip: Phone:
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 confederation 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,
access 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
commencing work or recording vour Notice of Commencement.
I
loq
Sign t re of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLCOUNTYOFORIDA �ci_�
OF ORIDA S� ��Q_
I
COUNTYOFSTATE
The forgoing instrument was acknowledged before me
The for oing instrument was acknowledged before me
this f2LA day of N Dy _ 20 \' by
this? day of \)i Q"1- 20J_%by
Name of personyaking statement
Name of person making statement
Personally Known 1/ OR Produced Ide\I�`ll�(A�
Typel
Personally Known OR Produced Identification
Type of Identification
of entificati
Ss
Produced ed SAMA Y.
Produ eltl `J`PQO�\
oygyn
\\`\`��O�\Np
SION •'•.
Oo9
(Signature of No a P c State of F Aa) 9FfW21 �„o`
(Signature of Notary Pu II / e rNrIclaT* ; tFF9yy2yg
i,Ty�y� NtO�arYW"E5c���``�dS
Commission No. �FDIS`{t:�j `�BLIC
Commission No. �F d1 / i2\� (Se'9yY:°ajA�u
5tPt�O``��\
///IIIHIrl111111\\I
,,/7j ��Will 1 O 1
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
1
�
RECEIVED
1LE\
DATE
COMPLETED
Rev.B/2/17