HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
1213/2018 Permit Number:
Building Permit Application
Plannirtgand Development Services DEC 03 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 L
Lucie County, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Re
PER IT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION: ('� 6
Addres:18101WAGONWHEELLN.-FrrErcE O(�' U 3-1 1 G NP
Legal Description: LOT 11, CARLTON COUNTRY ESTATES �t BY
Property Tax ID #: 3211-701-0013-000/3 Lot No. 11
Site Plin Name: Block No.
Project,Name: SANDLIN RESIDENCE
Setbacks Front 130' Back: 343' Right Side L9k Side:
DETAILED DESCRIPTION OF WORK:
NEW SINGLE-FAMILY RESIDENCE; 5 BEDROOMS, 3 BATHS w/ 2-CAR GARAGE.
CONSTRUCTION INFORMATION:'
Additi.ral work to be nertornried under tispermit-check all app
Z✓y:
VAC Gas Tank Gas Piping Shutters ❑ Windows/Doors
❑✓— lectric ❑✓_Plumbing Sprinklers _ 6/1 Generator 7 Roof 2 Roof pitch
Total S. Ft of Construction: 3401 S . Ft. of First Floor: 2610 A/C & 881 non -living
Cost oflConstruction: $ ya!• z% Utilities:Sewer W1Septic Building Height: 18'
OWNER/LESSEE::
CONTRACTOR:
Name RUBIN SANDLIN
Name. GREG OLDAKOWSKI, PRIES.
Add resls:1805
AVE E
Company: GRANDE CONSTRUCTION OF FL., INC.
City: FT
Zip Co
Phone
PIERCE State: FL
e. 34950 Fax:
INo.
Address: PO BOX 881765
City: PORT ST LUCIE 'State: FL
Zip Code: 34988 Fax:
Phone No. 772-336-7240
E-Mail:
Fill in fete simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: GREG@GRANDEFL.COM
State or County License: CGC1505127
If valueiof construction is $2500 or more, a RECORDED Notice of Commencement is required.
0
SUPPLEMENTAL CONSTRUCTION
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 contllct 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
commencingwork or recordingour Notice of Commencement.
Rev.8/2/17
LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: i42wr*c��sm.n�-, lam.
MORTGAGE COMPANY:
Name: cs•.+7� sTora3o.�c, TI.A,
Not Applicable
Address:8o(v Ds�.aNP� .off•
Address: +aosnvEE
City: IFTPIERCE State: Pt_
Zip: �`{5S o Phone 4t�o-�7s1
City: PORTSTLUCIE
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY:
Name:
Not Applicable
Address: Poeoxaa+7ss
Address:
City:
City:
Zip: Phone:
Zip: Phone:
p)z; s.
psvW .
ign ture of Owner/ Lessee/Contractor as Agent for Owner
Ign ure of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St. l,vc.(e
COUNTY OF S7. Lvc.Ae
The fo�oing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this3— day ofpac5r7+3°+'i- 20Lby
this 3R day of1fcr>w16nyL ,20Lby
0 l�.bkm>JSG+ , P,irr.
�rtA 63 0 t.,piJ)Cp.vS It I �n1'+•
Name of person making statement
Name. of person�naking statement
Personally Known ✓OR Produced Identification
Personally Known !/ OR Produced Identification
Type of Identification
Type of Identification
-produced
Produced
i
D(Coa
(Signature of No
6F{erid
tlbvl'Vi7� DAVID J RKIEWICZ
e of Nota P
f ;,
,�;+�` :N JURKIEWICZ
Commission No.
'••E MY COMI(88SION # FF998909
Commission No.
•'= MY COON # FF980909
.1';
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EXPIRES June 05, 2020
.' EXPIRES June 05, 2020
(007)388-0153 FIOMaNOUrySorvlce.com
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