HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNEn Permit Number: 109 - �M57
BY
St. Lucie CountV
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 X Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 7773 Pine Lakes Blvd, Port St. Lucie, FL 34952 (Building # 1) 1 st Floor
Legal Description: PINE SUMMIT (PB 40-13) TRACT D (31.76 AC) (OR 3929-972)
Property Tax ID #: 3422-596-0007-000-6
Site Plan Name:
Project Name: Arium-Pine Lakes
Setbacks Front Back: _ Right Side: _ Left Side:
DETAILED DESCRIPTION OF WORK:
Install radon mitigation (Mechanical Ventilation) system with electrical as per plan
Lot No.
CONSTRUCTION INFORMATION:
Aoditionalwon(toDe ertormed underthispermit — cneCK all Inar apply:
E:1HV f! Gas Tank E]Gas Piping Shutters []Windows/Doors
ElElectric ElPlumbing []Sprinklers Generator 0 Roof Roof pitch
Total Sq. Ft of Construction: 400
Cost of construction:$ 1,000-00
S Ft of First Floor: 1,039
Utilities,C2 Sewer 0 Septic Building Height: 3 Story
bWNER/LESSEE:
CONTRACTOR:
Name EIR Carroll St Lucie, LLC
Name: Gene Yacobacci
Address:.3340 Peachtree Road NE, Suite 2250
company: Radon Mitigation Services, LLC
city: Atlanta State: GA
Zip Code: 30326 Fax:
Phone No. 772-245-4530
Address: 3361 5th Ave SW
city: Naples State: FL
Zip Code: 34117 Fax: 407-386-7759_
Phone No. 239-340-0027
E-mail:-Eugene.Harrell@carrollorg.com
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E-Mail: radonfix@aol.com
State or County License: CAC 1816667
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGN ER/ENGI NEER:
Name:
X NotApplicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
State:
City: State:
Zip: _ Phone:
FEE SIMPLE TITLE HOLDER:
Name:
ot Applicable
BONDING COMPANY: _,;KUot 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. Lucie Count makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in cc Mict with any applicable Home Owners Association rules, bylaws or ang 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
commencine work or recordine vour Noticeof Commencement. - A
SignRure of Owner/Lessee/Contractor as Agent for Owner
Signature ofICorfractor/License Holder
STATE OF FLORIDA 064%
STATE OF FLORIDA
COUNTYCIF 'Cwl' /V
COUNTY OF COLLIER
The forgoing instrument was acknowledged before me
this _Wday of July 20 i7 by
&4
Personally Known _4—OR
Type of identification Produce(
Commission No.
otary Public, Fulton County, GA
,onimisslon Expires June 12. 2
Revised 07/15/2014
TARy
The forgoing instrument was acknowledged before me
this 12 day of July 20 17 by
Gene Yacobacci
(Name of person acknowledging I
VIgnature of Notary Public- State of Florida I
Personally Known X
Type of Identification Prodi
Commission No.
M Ia
Y=. AP11 1#36 =202M1 0
BoNed 11ough Ut SM lmwm
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r a
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
BY
St. Lucie Countv
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 X Residential
I PERMIT APPLICATION FOR: Electrical III
Address:.7773 Pine Lakes Blvd, Port St. Lucie, FL 34952 (Building# 1) 1st Floor
Legal Description: PINE SUMMIT (PB 40-13) TRACT D (31.76 AC) (OR 3929-972)
Property Tax ID #: 3422-596-0007-000-6
Site Plan Name:
Project Name: Ariurn Pine Lakes Apartments
Setbacks Front Back: - Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install one receptacle for radon fan. 40W, OAA (See Plan Sheet El)
Lot No.
Block No.
I CONSTRUCTION INFORMATION: dil
E1HVAC Gas Tank
11 Electric Plumbing
Total Sq. Ft of Construction: 400
Cost of Construction: $ 200.00
Piping Ll Shutters Windows/Doors
nklers 1:1 Generator Roof Roof pitch
5 Ft of First Floor: 1,039
Utilities,12 SewerE]Septic Building Height: 3 Story
OWNER/LESSEE:
CONTRACTOR:
Name BR Carroll St Lucie, LLC
Name: Michael T. Lang
Address:_3340 Peachtree Road NE, Suite 2250
Company: Mike Lang Electrical Cont., Inc.
city: Atlanta State:GA
Zip Code: 30326 Fax:
Phone No. 772-245-4530
Address: 5408 San Roma Circle
city: Lake Worth State: FL
Zip Code: 33467 Fax:
Phone No. 561-723-2895
E-mail:-Eugene.Harrell@carrollorg.com
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E-Mail: mikelangelec@yahoo.com
State or County License: ECO000227
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
,SUPPLEMENTAL CONSTRUCTION* LIEN LAW INFORMATION -
DESIGN ER/ENGIN EER:
Name:
X NotApplicable
MORTGAGE COMPANY:
Name:
KNot Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: _ Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
X
BONDING COMPANY:
Name:
Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: _ Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
StAucieCoun makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in co 1%ct with any applicable Home Owners Association rules, bylaws or an9covenants 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
commencine work or recordine vour NoUL4 of Commencement. I I-0
Signature of Owner/Lessee/Contrac&f as Agent for Owner Signature of Contract-or/license Holder
STATE OF FLORIDA amq�g+ STATE OF FLORIDA
COUNTYOF Z A/ COUNTY OF COLLIER
The forgiping instrument was acknowledged before me
this 7Vday of July 20 17-by
t,4
of
Personally Known _ _OR
. 74.
Type of Identification Produce
Commission No.
Notary Public, Fulton
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this 12 day of July 20 17 by
Michael T. Lana
(Name of person acknowledging)
Anz4vtt=E:
(SigAture of Notary Public- State of Florida I
Personally Known X OR Produced Identification
Type of Identification Produced
E * . 0410. "1 W � eamnsul TS&R0141 POPU08
.(s _�* Commission No. GG09431
eAll � . Z
L909 % - IdX3
GA 0=95#N0IS9[WW00AW
--REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS