HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED G V �}
Date: ` ( Permit Number: lO ()366
_ SCANNED RECEIVED
BY ® SQ. Lucie GouPiQg/ MAY 14 2019
Buildin Permit A licaton
- -- - - --- g pp iper ltling Deie punty
artment
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMITTYPE:
PROPOSED iiVl'RROUEIVIENTFLOCAf ION
Address: 4705 Elm Ave Fort Pierce FI.34982
PropertyTax ID #: 3404-501-0632-000-6
Site Plan Name: Elm Ave
Project Name: RJM Custom Homes / Allih
Lot No.
Block No.
Additional work to be performed under this permit — check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 3015 Sq. Ft. of First Floor: 2232
Cost of Construction:$ 3U// r*d Utilities: _Sewer )(Septic
Building Height: 22'
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CONTRACTOR "
Name Justin & Amanda Allih
Name: Kimberly Bunner
Address:5802 Palm Drive
Company: RJM Custom Homes
City: Fort Pierce
Zip Code: 34982 Fax: N/A
Phone No. (772) 216-8248
State: _
Address: 6917 Vista Parkway North Suite #1
City: West Palm Beach State: FI
Zip Code: 33411 Fax: N/A
Phone No (561) 267-7476
E-Mail:-amaridamd8lO@hotm.a.ii.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail michael@rjmcustomhomes.com
State or County License CBC1256527
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.
�SUPPLEMENTAICONST.RUCTiON LIEN L/�W (NFORMATI0N
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _
Not Applicable
Name: RICK BOYETTE
Name: CENTER STATE BANK
Address: 4031 COCONUT BLVD
Address: 2100 SOUTH PARROTr AVE
City: WEST PALM BEACH State: FL
City: OKEECHOBEE
State: FL
Zip: 33411 Phone (561)790.5766
Zip: 34974 Phone: (863)763-5573
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not
Applicable
Name: FIRST AMERICAN TITLE
Name:
Address: 1555 PALM BEACH LAKES BLVD
Address:
City: WEST PALM BEACH
City:
Zip: 33401 Phone: (561) 626-8443
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sto%fure of Owner/ Lessee/Contractor as Agent for Owner
Sigiliature of Contractor/License Holder
STATE OF FLOR A
M
STATE OF FLO{�1�p
M Ch
COUNTY OF �}Qln .
COUNTY OF 1�1
The forgoing instrument was acknowledged before me
this Z> day of E{Or-1 26ji by
The for oing instrument was acknowledged before me
this day of 20- T by
� llm . to n eyL
r i 'M � n ne ((-
Name of person making statement.
Name of person making st ement.
✓
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identi '
Type of Identification
uced I ANA M. DEL MONTE
ed
MY COMMISSION # GG007376
�!"'y;•; A A M. DEL MONTC
ITProd
EXPIRES June 29, 2020
e = MY COMMISSION # GG007376
•-�? '
(407)39"153 FI0ndaN0Wry9ervice.mm
,A EXPIRES June 29. 2020
ignat f e of Notary Public- State of Florida)
Signat o 4g a
Commission No. (Seal)
Commission No. (Seal)
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DATE
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DATE
COMPLETED
Rev.2/7/19