HomeMy WebLinkAboutBUILDING PERMIT APPLICATION. __
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 T_,'b SCANNED Permit Number: L04 cm— ozk %d
BY
St. Lucie County RECEVED
Building Permit Application[APR 10 'ZOt8Planning and Development ServicesBuilding and Code Regulation Division ucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEMENT LOCATION:
Address: a00 S• Oc�A J 24—. Aae-TA 7o,,,re62
Legal Description: REGENCY ISLAND DUNES TWO CONDOMINIUM
Property Tax ID #: 3534-502-0000-0000 (R ee�ee'1j
Site Plan Name: Regency Island Dunes
Project Name: Porto Cochere Repair
Setbacks Front NIA Back: NIA Right Side: NIA
DETAILEDDESCRIPTION OF WORK:.
Repair damaged Porto Cochere
Left Side: NIA
Lot No.
Block No.
CONSTRUCTION INFORMATION: III
__JGas Tank UGasPiping LJShutters
ElPlumbing []Sprinklers Generator
Total Sq. Ft of Construction: 400
Cost of Construction: $ 12,000
Sq. Ft. of First Floor: _
Utilities: ZSewer DSeptic
Windows/Doors
11 Roof = Roof pitch
Building Height: 20�
OWNER/LESSEE:
CONTRACTOR:
Name a / P .
Name:MAT4aw PAMI%cb"S
r
Address: �w •
Company: CCD of Stuart, Inc., DBA Commercial Contracting Division
Address: -7e9 Sif S5-R-z i
City: oTPh &?,o /i -4) State: FL
Zip Code: 34957 Fax:772.229.0140
Phone No.772.229.0311
City: State: FL
Zip Code: 34994 Fax: 772.283.2855
Phone No. 772220.3488
E-Mail: ddmgr@the-regency.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: mmattison@ccdofstuart.com
State or County License: CGC 1526229
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _
Name: T , f
Not Applicable
cer) 'o
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 1595.F�'17'an Aker
Blvd, C2/b
Address:
City:yer0 A" CA
Zip: 32980 Phone772.360.4998
State: Ft
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _
Name:
Not Applicable
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 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.
�LZ_t,�Ltl�Efiit� dY�
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q&natolof Owner/ Lessee/Contractor as Agent for Owner
Signature df Contractor/Licensolder e
STATE OF FLORIDA c� %
STATE OF FLORIDA
COUNTYOF L J
COUNTYOF MA%2;In)
The forgoing instrument was cknowledged before me
thisol—A %�i(Zc� 201,Y by
The forgoing instrument was acknowledged before me
this 10 day of Ar$Lltr 20JA by
1
JWc4oyJV
Mathew Mafliwn '
me of person making statement
Name person making st ement
Personally Known � OR Produced Identification
Personally Known _ OR Pro ced Identification
Type of Identification
Type of Identification
Produced
Produce
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( 44v_ a
"lar FAM�R
(Signature of NV53
(Signatu a of tary Public -State of Florid
ISS F9N270Commission No��If
CommissionNo. 30 [$3 eaAPRIL LARA
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D�wmber O8. 2019
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DATE
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Rev. 8/2/17