HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: f 0 — 6--A _5A,_ Qrahihir_ Permit Number: (q0(0- 009
BY
St. Lucie County
Building Permit Application
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
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I PERMIT APPLICATION FOR: Siding III
I PROPOSED IMPROVEMENT LOCATION: III
Address: 138 COMMONWEALTH CT, FT. PIERCE, FL 34949
Legal Description: QUEENS COVE -UNIT 1- BLK 14 LOT L(OR 874-2566)
PropertyTaxlD#: 1414-701-0132-000-0
Site Plan Name:
Project Name: DONALDSON
Setbacks Front Back: _ Right Side:
Left Side:
Lot No. L
Block No. 14
I DETAILED DESCRIPTION OF WORK: III
INSTALL JAMES HARDIE SIDING ON ENTIRE HOUSE
CON RUCTION INFORMATION:
AaU_
10�al worKtol3epertormed under this permit —check all that applly:
1]HVAC LiGasTank 0Gas Piping Shutters' E]Windows/Doors
Electric ElPlumbing OSprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ C2 1 , -7-7,S—
S,C Ft of First Floor:
Utilities* L] Sewer E]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name DON DONALDSON
Name: MICHAEL HOLEMAN
Address: 138 COMMONWEALTH CT
Company: HOLEMAN INC.
City: FT. PIERCE State: FIL
Zip Code: 34949 Fax:
Phone No.' (772) 260-1969
Address: 212 N US HWY 1, #17
City: TEQUESTA State: FL
Zip Code: 33469 Fax: (561) 743-3787
Phone No. (561) 743-0687
E-Mail: ddonaidson5@bellsouth.net
Fill in fee simple Title Holder on next page I if different
from the owner listed above)
E-Mail: colleen@holemanine.com
State or County License: CBC1 25217
It value of construction is $2500 or more, a RECORDED Notice at Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _NotApplicable
Name:
BONDING COMPANY: —Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.LucieCoun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conlict 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
commencinR work or recordine vour Notice of Commencement.
Signature of Owner/Lessee/Contractor 63Ageotfor Owner
s
�ignature of Contractor/License Holder
STATE OF FLORJ� STATE OF FLO
COUNTYOF a r-h e\ I COUNTY OF- MM R�P_OZJ-,J
The forAping instrument was acknowledged before me The ing instrument was acknowledged before me
thisalaclayof M 20 LL�_by this iry of M qJ 20 by
(Name of person acknowledging) (Name of person acknowledging)
61-0_0� 1 M�n! —
(Slgnatu�e of Notary Aublic- State of Florida (Sighfure of Notaky-EubAc- State 6f %rida
Personally Known t"_�Olt Produced Identification
Type of Identification ProducedA!f-N WSWM V=
?; KYWW01041FF2275M
Commission No. FF,2176,5e;)*' (MrE&'A*ist30.2Q19
'Von .... ... Strilais
Revised 07/15/2014
Personally Known �Z OR Produced Identification
Type of Identification Produced 10 a 0 a — — da"amd""
;�'y DANA SIMMONS
Commission No.66 329 YS'll e-i, : ootary Public - State of
7" MI'Sa Commission#GG32
My Comm. Expires Apr I
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