HomeMy WebLinkAboutBUILDING PERMIIT APPLICATIONATC 412253
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
SCANNED
BY
St. Lucie County
Permit Number: 1� - U(Z I
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
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEMENT LOCATION:
Address: 4690 Emerson Ave, Fort Pierce, FL34951
RECEIVED
JUL 0 2 2018
5T, Lucie county, Permitting
Residential
Legal Description: 14 34 39 N 170 FT OF S 1/2 OF NW 1/4 OF SW 1/4-LESS CANAL AND RD RS/W- (5.05 AC) (OR 3114-2638)
Property Tax ID #: 131432300010006
Site Plan Name:
Project Name: ATC 412253 RUSSAKIA INDRIO RD
Setbacks Front Back: Right Side:
Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: III
VA V:I1 04111ra►l►r-AIIIIIJ11111lc]l;0_v:1
CONSTRUCTION INFORMATION: III
AaamonaiworKioDe
OHVAC
errormea
unaerinisperm¢-cnecKau
Gas Tank Gas Piping
appry:
Shutters
❑
Windows/Doors
_
❑✓— Electric
0 Plumbing
Sprinklers
1:1 Generator
��7Rloof
Roof pitch
Total Sq. Ft of Construction: ScFt. of First Floor:
Cost of Construction: $ ZOO- Utilities: Sewer 0Septic
V
Building Height:
_
OWNER/LESSEE: LESSEE
CONTRACTOR:
Name ATCSEQUOIALLC
Name:
Company:
L
Address: 10 PRESIDENTIAL WAY
City: WOBURN State: MA
Zip Code: 01801 Fax:
Phone No.781-926-4500
Address- '8801inB��R�B,�y°n
e,F�34°0?�',�--.
City:'�CIO O C"O a
Zip Code: 33y01
Phone No. "Tw S46-
State:_
Fax: &
7
E-Mail: batufford@tepgroupnet
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: %iit
(a1XD'hS iel e f(IC
State or County License: _,
77'
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Not Applicable I MORTGAGE COMPANY:
Address: Address:
City: State: City:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Russakis Investments LL
Address: 8801 Indno Rd, Fart Pierce, FL 34951-1615
City: Fort Pierce
Zip:34951 Phone:
BONDING COMPANY:
Name: WA
Address:
Zip:
x Not Applicable
X Not Applicable
)WNER/ CONTRACTOR AFFIDVIT: Aoolication is herebv made to obtain a hermit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
r
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 andppsted on the jobsite
before the first inspection. If you intend to obtain, financing, consult with lender an attorney before
commencing wprk or recording our Notice of Commencement.
By:
Signature of Contract icense Holder
Signature of ner/ Lessee Contractor as Agent for Owner
Margaret Robinson, Senior Counsel, ATC Sequoia LLC
STATE OF.MASSACHUSETTS
STATE OF FLORIP�
COUNTY OF MIDDLESEX
I
COUNTYOF
The forgoing instrument was acknowledged beforemeThe
for ing instr ment was acknowledged before me
this I� day of f t_ •a' 20 18 by
* a`, by
this day of�,�,f
MARGARET ROBIN, SENIOR COUNSEL, ATC SEQUOIA LLC
"20q
Name of person— caking statement
Name of person making statement
Personally Known x OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Produced'
Produced
ALm�Lt2 A&=�
(/�Inc 1&6r�
—
(Signature of Notary Public- State of Massachusetts I
ignature of Notary
Public- Statl
Commission No. MELISSAS Rat)tJ METZLER
Commission No.
,�ytirpry.; CIAUDETTEMAR�j� L
rpA-MOGG1BB
Notary Public
:1• �, WresMay K2022
,
Commonwealth of Massachusetts
IF
i' °Gh° 9oNedlMrir112*1lism oca6W,98�TC18
My Cc
mission Expires
March 14. 2025
REVIEWS
P
VEGETATION
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MANGROVE
COUNTER
REVIEW
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REVIEW
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DATE
I ��
RECEIVED
`
DATE
COMPLETED
Rev.8/2/17