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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �),• I D , SLANNED Permit Number: - ©� l Uetl fs';, St. LucieCoun4v R ECEIVED • Building Permit ApplicaEP 10 2019 Planning and Development Services Building and Code Regulation Division ie County, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ✓ PERMITTYPE: Rp -roofs' PROPOSED IMPROVEMENT LOCATION: Address: 5009 Paleo P nes Cir. Foci Fierce- FL 34951 Property Tax I D #: 1312. -got - o l 41 - 0oo -a Lot No. 3 3 8 Site Plan Name: Block No. Project Name: Ne� cln DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: AddiEieAa'work to be performed under this permit -check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors _Electric _Plumbing _Sprinklers _Generator ✓Roof 5:12 Pitch Total Sq. Ft of Construction: 3.` R 7 Sq. Ft. of First Floor: Cost of Construction: $ 22 - 3 7 5 Utilities: -Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Tom Ciclnoeki Name: Daniel Scroka Address: Soo9 Pale, P;. y t Cir Company: Soroka Reagibq I Le City: Fork dierce State: _EL Zip Code: 349 5 I Fax: Phone No. (772) 203 -89S7 Address: PO box (oSoo 2L City: Vero Aea e h State: F L Zip Code: 32965 Fax: Phone No (772.) 231 - 1983 E-Mail: iomar%d5jir'359!29,„e;I.eo&m Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail Soroka rocA'vioCy a ti . n e b State or County License C CC 13 3000 5 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: v Not Applicable Name: MORTGAGE COMPANY: ✓ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: ✓ Not Applicable Name: BONDING COMPANY: ,Not Applicable 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 JJ�B SITE BEFORE THE FIRST INSPECTION. IF YOU INT� TO OBTAIN FINANCING, CONSULT WITH YOUR LE OR AN ATTORNEY BEFORE RECORDING YOUR NOTI OF COMMENCEMENT" X�t= ��' Zf(,- . -.4 Signature of Ow er/ ssee/Contractor as Agent for Owner Signature of o tractor/License Holder STATE OF FLORIDA L 1 STATE OF FLORIDA / COUNTY OF ,]/1 LUi! /G_ COUNTY OF . L"r The for oing instru nt wa acknowledgedbefore me this day The for oing instru nt wa acknowledge efore me by of20Zby this7dayof��20 Name of person ma Ing statement. Name o person making statement. Personally Known OR Produced Identification ,// Personally Known OR Produced Identification Type of (dent' ion Type of Identificaf' Produced L Produced i I (Signature of t GJlVy1ic-516AL9§ I ri (Signature of �,'w: oa, KAREN S. NIELSEN State of Florida -Notary Public Commission N Commission yy GGG,,207484 sy ommisA fl0lflxpires ` Commission ;:° '�:=State of Florida-N�F�r���public - r^��,'ssion June 12, 2022 N Gfi'2U9484 Commission Expires npV" June 17 mg REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED CODATE MPLETED Hev. 211119