HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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1I Building Permit Application 19 10%
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lanning and Development Services SCANNED
B uilding and Code Regulation Division ,er ,0 (J C,1350
2300 Virginia Avenue, Fort Pierce FL 34982
St Lucie
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial QoEI yntial x
PERMIT TYPE:
PROPOSED INPROVEMENT LOCATION:
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Address: TBD PALM DRIVEjr-(L+$Z r j 1�ofG� 5��?j frl ►/C '
Property Tax ID #: 342e=E09-0358-000-6 T/��; i� �.i �i/ d� S_�4 It, Lot No.40
P o'ectName: �:
W59#( k,-,S VvvAq. •4 s J, - 0
DETAILED DESCRIPTION OF VUORKi'
NEW CBS 3-2-2
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CONSTRUC N INFORMATION: :F {?; 4
Utilities: _Sewer _Septic Sq. Ft. of First Floor: 1764
Cost of Construction: $ 0 o714,103, GD Total Sq. Ft of Construction: 1764
FLOOQPLAINDEVELOPMENT PERMIT, for structures exempt,from Buil ode that are in the
floodplain; .
Nonresidential Farm'Building: Temp. Bldg /Shed u exclusively for, construction,.
Mobile) Modular fortemp, constructi ffice g. involved in dlstrib. of'electncity:
Other._ __ o He: iBFE;_ Floodway?`Y/N .IfY,
No Rise Certificate with supporting data,.atta
All applicable stateand federal " rmit"s shall be obtained p,tol commencement;of
.other
construction, .;
OWNER/LESSEE: ',
C,0NTRACT,0R:' _
Name KENNETH JONES
Name:PHILIP PETRUZELLI
Address.716 GARDENIA AVE
Company: PORT ST. LUCIE PROPERTIES, INC
City: FORT PIERCE State: _
Address:2401 SW MONTERREY LANE
City: PORT ST. LUCIE State: FL
Zip Code: 34982 Fax:
Phone No. 772-209-1890
Zip Code: 34953 Fax:
E-Mail:
Phone No772-249-0086
Fill in' fee simple Title Holder on next page ( if different
E-Mailpslpropl224@gmail.com pslpropl@gmail.com
State or County Licensecbc1257923
from the Owner listed above)
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.
SUPPLEME-NTAL CON,STRUCTION,ILIEN LAW IN ',0 MAT ION;
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY: _
Not Applicable
Name: PAUL WELCH INC
Name: GOLDWATER BANK
Address: 1984 SW BILTMORE BLVD
Address: 7135 CAMELBACK RD
City: iPORT ST. LUCIE
State: FL
City: SCOTSDALE
State: AZ
Zip: 34984 Phone772-785-9888
Zip: 85251 Phone; 800-281-6446
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.
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 contlictwith 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
commencinia-work or recording vour Notice of Commencement. _
Signature of Owner/ Lessee/Contract-or as Agent for Owner
Signature of Contractor/License Ho der
STATE OF FLORIDA,.,
STATE OF FLO A
COUNTY OF o)-1 . (k XA�—
COUNTY OF . � wici 'e—
The for Ing instrument yvas acknowledg before me
this day of '=�( 20 by
The forg Ing instru ent was ac nowledged before me
this day of n 2tl by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known !OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Sign�YNo - TO
(Signature of Notary
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