HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Nu a O
t- RECEIVED
Building Permit Appli
DEC - 7 2018
Planning and Development Services
Building and Cade Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 S.t LUc•e linty, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line keJV v �) r-
PROPOSED IMPROVEMENT LOCATION:
Address: 4204 Citrus Avenue, Fort Pierce, Florida
Legal Description: The South 100' of the West 770 feet of Outlet 5, Town of White City, florida
SCANNED
Property Tax ID #: 3404-501-0513-000/6 RY Lot No.
Site Plan Name: POLK RENOVATION
Project Name:
POLK RENOVATION
St. Lucie
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK:
Block No.
this is a renovation of an existing home in white city —the demo work is mostly complete as only "odds and ends" left to do.
electrical rewiring to be done, update plumbing in building, new insulation ang( Wall, install a/c units (2). Porch on south side to be
totally rebuilt. All windows being replaced in building. Repair garage roo°f, ins all some electric, and new ho water heater.
66r el-f rl o •>- o t r). p wf +r'i r-) 4--
I CONSTRUCTION INFORMATION. " '- o " 1
ZHVAC
Gas Tank
❑Gas
Piping
11
Shutters
QWindows/Doors
ZElectric
0
Plumbing
Sprinklers
E]
Generator
D
Roof
=
Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 75,000
S Ft. of First Floor:
utilities :Sewer OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Camille and/or Steve Polk
Name: owner/builder
Address: 276 Summer Road
Company:
City: Port St Lucie State: Fla
Zip Code: 34983 Fax: none
Phone No. 214-693-8600
Address:
City: State:_
Zip Code: Fax:
Phone No.
E-Mail: thepolks2005@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or County License:
II If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. II
J
M,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INEORMATION:
DESIGNER ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: brianl.maskol Name: net applicable
Address: 725 se port st lucie boulevard, suite 203 Address:
City: port stluoie State: na City: State:
Zip: 34984 Phone 772-285-0572 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: same
Add ress:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: none
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
commencine work or recordine vour Notice of Commencement.
t Jl) wr;
oyrs:'
lig- a'turre of, 0_ w_Rr essee/Contractor as Age
i;fa�r•.
r
Signature of Contractor/License Holder
STATE OF FLORID
STATE OF FLORIDA
COUNTY OF
m<
a x�>
COUNTY OF
The for ping instrument was acknowledged b
The forgoing Instrument was a nowledged before me
this day of _ Ui� 20J
this _day of 20_ by
L'e�o!v
Name of person making statement
Name of pers nmaking statement
Personally Known OR Produced Iden
Personally Known OR Produced Identification
Type of Identification
Produced -'r w --b dc�' L I C •
a, I dhl4
Type of Identificat' n
Produced
(Slgna ure of N y Public- State of Florida
(Signat(yfe of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
aII�
RECEIVED
DATE
COMPLETED
Rev.8/2/17