HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date:- Ir 11— SCANNED Permit Number:BY
= St. Luce County
Building Permit Application NOV 0 7 Y017
., Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
FL 34982
2300 Virginia Avenue, Fort Pierce
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential 4-
PERMIT APPLICATION FOR: Window/door
PROPOSE D,IMRROVEMENTLOCATION. "
Address: 12358 Harbour Ridge Blvd, Palm City, FL 34990
Legal Description: South Shore Village Unit 3-7 (or 3877-355)
Property Tax ID N: 4426-807-0023-000-4 Lot No.
Site Plan Name: Hardin Residence Block No.
Project Name: Hardin Residence
Setbacks Front Back: Right Side: Left Side:
IDETAILED"DESCRIPTIOROF WORK: ;, ;
Replace 6 windows to PGT white Aluminum Impact Rated Glass. Please see drawing and NOA
CONSTRUCTION INFORMATION: ,-
un ert ispermi c a appy:
itiona wor to e e line —ec
MGasTank E]GasPiping LVzWindows/Doors
❑HVAC _Shutters
OSprinklers ❑Generator I ❑ Roof pitch
❑Electric ❑Plumbing JRoof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 18,100.00 Utilities:Sewer ❑Septic Building Height:
OWNER/,LESSEE. -,
CONTRACTOR'
Name Laura Hardin
Name: Steve Rubin
Company: Rubin Custom Homes
Address:12358 Harbour Ridge Blvd 3-7
Address: 4253 SW High Meadows Ave
City: Palm City State: FL
Zip Code: 34990 Fax:
City: Palm City State: FL
Phone No. 201-7016
Zip Code: 34990 Fax:
Phone No. 772-283-0553
E-Mail:
Fill in fee simple Title Holder on next page (if different
E-Mail: receptionl.rubincustomhomes@gmail.com
from the Owner listed above)
State or County License: CGC1518190
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: Not Applicable
_
MORTGAGE COMPANY: ✓ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
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 County makes no representation that is granting permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws orand 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.
Inconsideration 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
commencing work or recording our Notice of Commencement.
Signature of owner/Lessee/Contractor as Agent for Owner
Sig -nature of Contractor/License Holder c
STATE OF FLORIDA
COUNTY OF 11)64
STATE OF FLORIDA Cam. � . C
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COUNTY OF Wr—
The fgJ�oing instru was acknowledged before me
this ay of
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The f r Ing inst m t c acknowledgerd�"before me
this day of ��LQ- 20� 1 by
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(Nam f ers acknowledging)
(Name of Perspri acknowledging)
(Signature of Notary Public- a, rida)
(Signature of Notary P li'
Personally Known uoE'�Rt tion
Personally Knocatio
Type of Identification Pro';` °m • kF/
Type of Identification Produced
Commission No. pSgPlSergAr9
mmission No.
�p�y�020
Revised 07/15/2014 a'0r9
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS