HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5���� SCANNED Permit Number:\C\GS-01ro�
St. Lucie County RECEIVED
. Building Permit Application MAY 0 7 2019
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Other ® II
PROPOSED IMPROVEMENT LOCATION:
Address: 13054 NW Gilson Road Palm City, Florida 34990
Legal Description:
Property Tax ID #:
Site Plan Name:
2-0020-000-1
Project Name:
Setbacks Front Back:
Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Detached Garage ;affit, e-f7�1,e-cy-4 e- eNb t
30 XL.1 p�
a
CONSTRUCTION INFORMATION:
Lot No._
Block No.
G
tAuuuwud1 WU1K w ue
HHVAI
envnneu
Gas Tank
unuei
uio
❑Gas
PcnmL—LIMUN du
Piping
apply.
Windows/Doors
_Shutters
19 Electric ❑ Plumbing
❑Sprinklers
❑ Generator
❑
Roof ❑ Roof pitch
Total Sq. Ft of Construction: Sg 6. S Ft. of First. Floor:
d o
/Zit
�y/lae
Cost of Construction: $ ®�{
e-D—i - Utilities:
Sewer El Septic
Building Height: /f
OWNER/LESSEE:
CONTRACTOR:
Name PAryl aol5 Residence LLC
Name: Richard c Geisinger Jr
Address: 79 OO GlodCs Rond SUI le 4 02.
Company: Watermark Energy Solutions
City: Boon Ra+Dn State:
Zip Code: 339 34 Fax:
Phone No.
Address: 54 NW Dixie Hwy
City: Stuart State: FL
Zip Code: 34994 Fax:
Phone No. 772-215-1094
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: dchard@watermarkenergy.net
State or County License: CGC1504591
If value of construction is $2S00 or more, a RECORDED Notice of Commencement is required.
i"
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER*
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Add ress: 54 NW osue Hwy
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 worlpor recording your Notice of Commencement.
A?�
�[y// �iilol A.4 4
Signat re o O n r/ Le ee/Contractor as Agent for Owner
Sign�333tttture of Con�actor/Li n older
STATE OF FLORIDA
/
STATE OF FLORIDA
COUNTY OF Y
NVur_
COUNTY OF MaV1d
The forgoing instruT4Dtivas
acknowledged before me
The ff�o��r�pping inst men was acknowledge'd0before me
this —& day of OU
20 by
this�$3[lday of C E a 26 a by
C . 12
Name of person
1ng statement
Name of perso making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
J
Lj."M
(Signature of Notary Public -State of Florida)
(Si
)
&v! Pv%
'•''•
HIDUSLUNM
....,,, GETFi E MARINO
11
Commission No.
WY )
�' tote o} Florltle-Notary Public
Co ff
CtGeloT iort1F89-2628713
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1j1 December 22, 202:
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
VIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
`
DATE
COMPLETED
I !
Rev.8/2/17