HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Datels 1\ 1411`� C�1 i MK A SCA�NED umber:
BY RECEIVED
Iq io _0 L, St. Lucie County
�. .
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: Addition
PROPOSED IMPROVEMENT LOCATION:
Building Permit Applic tST._
rfov 0 4 2oi9
Lucie County, Permitting
Commercial Residential X
Address: 125 North Erie Drive, Lot 125
Property Tax ID #: 1433-210-0003-000-9 Lot No. 125
Site Plan Name: Block No.
Project Name: Tall Pines
DETAILED DESCRIPTION OF WORK:
Install driveway, carport and shed under carport
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_ Electric _ Plumbing _Sprinklers
Total Sq. Ft of Construction: 560
Cost of Construction: $ 20,000.
_ Generator
Sq. Ft. of First Floor:
Utilities: X_Sewer _Septic
—Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Bedrock Tall Pines, LLC
Name: William J. Bushkie
Address: 650 5th Ave FI 1601
Company: B.A.C.H. Land Development
City: New York State: NY
Zip Code: 10019-0015 Fax:
Phone No.
Address: 3418 W. Arch St.
City: Tampa State: FL
Zip Code: 33607 Fax: 813-253-8899
Phone No 813-559-8555
E-Mail:
Fill In fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail tonyf@bach-development.com
State or County License CBC1260502
IT value or construction is $z500 or more, a RECORDED notice or commencement Is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: v
DESIGNER/ENGINEER: _ Not Applicable
Name' David w.Smith
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 5272 Abbott Station Dr. unit 101
Address'
City: Zephyrhina State: FL
Zip: 33542 Phone8l3-78M314
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 IMPROYEMENTS 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
W YO R LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature Contractor/Lic se Holder
Sig of Owner/ Lessee/Contractor Agent for Owner
as
of
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF BlOsboma9h
COUNTY OF H1Osbomagh
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 7 day of October 20_J9 by
this 7 day of r 20-19 by
Susan Dennis -Agent
William J. Bushkie
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of N6fary P
Jnd
(Signature of Notary Pul
N"'""•. DONNALYNN RUSSELL
'yF' DO LYNN RUSSELL. MY(,6 ONNGG360719
Commission No.
MYC01(fdfl &0NMGG360719
Commission No.
>•: 30 2023
i? EXPIRES:J*30,2023
'f F?P�°` 9ondeCThruNRaYPubkUld"PrItars
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
j
DATE
COMPLETED
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