HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONO
All APPLICABLE
Date: 1
BE COMPLETER FOR APPQCATIOI,y TO BE ACCEPTED I 11 �y�[
Permit Number: 191 / . v / / i .
SCANNED
' r as
St. facie Count�uilding Pe m t Appi
Planning and Development Services : y
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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Permitting Department
St. Lucie County, FL
PERMIT TYPE: new construction residential
PROPOSED IMPROVEMENT LOCATION:.--i
Pine Dr 1
Property Tax ID #: 3409-505-0006-000-6
Site Plan Name:
Project Name: Crouse residence
�.DETAILE�D,-DESCRIPTION OF WORK:.
construct a single family residence with 4 bedrooms, 3 baths and a 2 car gargae
CONSTRUCTION INFORMATION':
Lot No.
Block No.
Additional work to be performed under this permit —check all that apply:
X Mechanical _Gas Tank _Gas Piping _Shutters X Windows/Doors
Electric >( Plumbing _ Sprinklers _ Generator X Roof 17 It Z Pitch
Total Sq. Ft of Construction: 3958
Cost of Construction: $ 400,000
Sq. Ft. of First Floor:
Utilities: _Sewer Septic Building Height: ZC S3/�
'OWNER/LESSEE:-h'= .
CONTRACTOR:
Name Chad Crouse
Name: James Trefelner
Address:5481 NW Sceptor Dr
Company:Trefelner Construction Inc
City: Port St Lucie State: _
Zip Code: 34983 Fax:
Phone No' 772-216-8452
Address:1760 Copenhaver Rd
City: Fort Pierce State: FI
Zip Code: 34945 Fax:
Phone No 772-201-9833
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail trefelnerj@bellsouth.net
State or County License 28600
It 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.
SUPPLEM,ENTALCONSTRUCTION LIEN LAW WGRMATION:.' }
DESIGNER/ENGINEER: Not Applicable
N a me: Southeast Building Engineers
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 5911 Pescara or
Address:
City: Pace State: FI
Zip: 32571 Phone 772-774-9086
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN AjffORNEY BEFORE RECORDING YOUR NOTICE OF COMM EMENT."
Signature o ner/ Lessee/ tractor as Agent for Owner
Signature Contractor/Li a Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF SAY
The fq{going instrument was acknowledged efore me
this b day of 02r 20 by
The fgsgoing instrument w s acknowledged before me
this d day of 20,9 by
Ines'
Na of person making statement.
Nam o person making statement.
Personally KnownV/ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
�
(Signature of Ngbli="-'=—='- cl
(Signature of
fit ;�,;��:<^{ }.; AUDREY B. HUMPHREY
Commission MyCOMMISSIONV941100817
(� ::,�_M"'�y;, AUDREYB.HUMPHREY
Commission No. ' MY GOMh91SSI0Pjf861j00817
r r. EXPIRES: March 6, 2023-?
'aor iCoc,:
,��,`�a'..'-
}<_: ; tIXPIRES: Mard16, 2023
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DATE
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COMPLETED
Rev.2/7/19