HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE
-ACCEPTED
Date:
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Permit Number:
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____ _._ ._ .__._._. Building Permit Application g 1019
and Development Services
eluilding and ode Regulation Div sion
permANa9 D cap vent
2300 Virginia Avenue, Fort Pierce F! 34982
SCA N 5t. We
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Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resigentialp,
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E�} Residential Building Permit
county
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Address:TBD �1J0 rDUhn zap ' - ierce Z)Ltq �
Property Tax ID q: 3403-702-0005-000-6
Lot N0.4
Site Plan Name:
Block No.
Project Name: Reals Residence
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Additional work to be performed under this permit- check all that apply:
_ Gas Tank _ Gas Piping
,`
Windows/Doors
/Mechanical _Shutters
Y Electric YPIumbing _ Sprinklers _ Generator
?� Roof Pitch
Total Sq. Ft of Construction: 3959 Sq. Ft. of First Floor: 2589
Cost of Construction: $- y/u�04 j a� Utilities: _Sewer _Septic
Building Height:
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Name Robert Reals Name:
Addre'ss:5340 NW Nekoma St Company:-
orp
City: Port St. Lucie State: _ Address:
Zip Code: 34983 Fax: City. ��^�—
State l�
Phone No.772-370-2047 Zip Coder'
Fax:
E-Mail;onequikss@bellsouth.net Phone NT'
Fill in fee simple Title Holder on next page ( if different E- a
from the Owner listed above) State or County License
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.
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _
Not Applicable
NaJ STEVE LICAUSI DESIGN GROUP. INC.
N a m e: CENTER STATE BANK
Jme:
Add reSs:430D GATOR TRACE DRIVE UNIT E
Address: 5081 OKEECHOBEE ROAD
City: FORTPIERCE State: FL
City: FORT PIERCE
State: FL
Zip: 34582 Ph One772-7858 65
Zip: 34947 Phone:772-400-2512
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 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
commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
s
COUNTY OF
The forgoing mstru nt was acknowledged before me
The forgoing instrument was acknowledged before me
this Ajday of 20_a by
this _ day of 20_ 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 "V— QLk"41
Produced
(SigKatufre of Notary Publi i a
(Signature of Notary Public- State of Florida )
.� ....
:aY 6i RIGRAM
•RAWIN6Lo �
Commission No.
=1311#GG27506p
ommission No. (Seal)
59:
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REVIEWS
FRONT
ZONING
SUPER
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
u{
DATE
COMPLETED
Kev. 9/2b/1tS