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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAQ|APPU MUST BE COMPLETEDFOR APPLICATION T0BE ACCEPTED ` Date: �������\�W���� Penm�Nunober� BY ���� �`.�*m�wouv"ty Building Permit Application Planning and Development Services Building and Code Regulation Division J30UVirginia Avenue, Fort Pierce FLJ498Z Phone: (772)4GI'1553Fax: (772)46I'1578 Commercial Residential X Address: 4705 Elm Ave Fort Pierce Fl. 34982 PnopertyTax|D#:3404-5O1'0882'0O0'0 Site Plan Name: Elm Ave Project Name: RJM Custom Homes/ Allih Demolition of Additional work to be performed under this permit —check all that apply: Electric GasTank — Plumbing Total Sq. FtofConstruction: Cost of Construccivz,�5 —Gas Piping __Sprinklers Shutters Generator Sq. Ft. of First Floor:_ Utilities: —Sevver _Septic Block No. ___Windows/Doors _Roof Pitch Building Height: UT Name Justin &Amanda Allih Name: Kimberly Burner Address- 5802 Palm Drive Company, RJM Custom Homes City: Fort Pierce State: Zip Code: 34982 Fax: N/A Phone No. (772) 216-8248 Address: 6917 Vista Parkway North Suite #1 City: West Palm Beach State: Fl Zip Code: 33411 Fax: N/A 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 C13C1256527 Ifvalue pfconstruction is $IS0Uormore, aRECORDED Notice ofCommencement isrequired. SUPPEEMENTALCONS,TRUCTION LIEN A�'W INFQRIVIATIQN 4 DESIGNER/ENGINEER: _ Not Applicable Name: RICK BOYETTE MORTGAGE COMPANY: _ Name: CENTER STATE BANK Not Applicable Address: 4031 COCONUT BLVD Address: 2100 SOUTH PARROTT AVE City: WEST PALM BEACH State: FL Zip: 33411 Phone (561) 790-5766 City: OKEECHOBEE Zip: 34974 Phone: (863)763-5573 State: FL FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: FIRST AMERICAN TITLE BONDING COMPANY: _Not Name' Applicable 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. 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT AN ATTORNEY Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIQA STATE OF FLORIDA COUNTY OF_� I M • 1612 -02" COUNTY OF The forgoing instrument was acknowledg d before me The forgoing instrument was acknowledged before me this!day of rMN �f 20IN by this —ft day of I" 20A by lCtuh (avrtvicgt2 l-Im &/►✓iLon Name of person making statement. Name of person maki ltatement. Personally Known OR Produced Identification Personally Known _ OR Produced Identification Type of Identification Type of Identification Signatur o 6ta Public- State of Florida I (Signature of N ANA M. DEL O TE • Q ,_ ANA M. DEL MONTE o_.., N 'ommisSion N5. _ Beall Commission No. - • MY COMMISSIIS)W)GG007376 SION G 07376 "7 ... :t EXPIRES June 29, 2020 EXPIRES June 29, 2020 °!`•` Flo allotery8ervica,wn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW It1xd4194R Lf n11