HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLAPPLICABLE INFO MUST COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `�' / SCANNED Permit Nu
- BY
St. Lucie County -
Building Permit Applicati I
Planning and Development Services
Building and Code Regulation Division
2300Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial
OCT 0 2 2018
Permitting Department'LII
St. Luce County, FL
PERMIT'APPLICATION FOR: To Select from dropbox, click arroWat the end of line III
Ocean Or
Legal Description: /t$lnTn/G4'r ./SLAWD DvNa$
Pro pertyTaxlDIN: 01)do - 0 0 0 /0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: NI/; Left Side: NIA
Cut opening in shear wall between PH2 and PH3 _
(bO? -066t
..__•__.._. .. __ �..- .. r-..........
❑HVAC Gas Tank [:]Gas Piping
..
. Shutters
❑ Windows/Doors
❑Electric DPlumbing
[]Sprinklers
❑Generator
11 Roof Roof pitch
Total Sq. Ft of Construction:
N1A
S . Ft. of First Floor:
N/A
.Cost of Construction:$ 850
Utilities: Sewer[jSeptic
Building Height:
Name /
.Name: Greg Mombito
Address: O « Z9 •
Company: GM Construction LLC
City:J=L. State: _
Address: 313 SW Albany Avenue
Zip Code�3 KS' Fax:
City: Stuart State: FL
Phone No._ g—D
Zip Code:34994 Fax:772-781-8505
. E-Mail: l/7n1e-,jQ A(°'/� i�NiC1ni
Phone No. 72-781-8500
Fill In fee simple Title Holder on next page ( If different
E-Mall: estima0ng2@gmconstructlonllc.com
from the Owner listed above)
State or County License: CGCO49743
If value of construction Is $2900 or more, a RECORDED Notice of Commencement Is required.
SUFRUEMENTA@C NSTRUM, ON UEN IA�WANFORMATIOW
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: le Not Applicable
Name- vfiedw&4mw6N .
Name: -
Address: --
Address: 1171esEFedwwiLwy
City: Hobe SMWA State: FL
City: State: FL
Zip: sass Phone72-ten
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: X Not Applicable
Name'
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.
which Is In connict with any applicable Home Owners Association rules, bylaws or andcovenants 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 (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 moms 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, conWit with 1 der or an atto ey before
commencingworkor recordingour Notice of Commence nt. I 'I
1/L
S' a-tu Owner( lessee Contractor as Agent for Owner
Signature Co ctor/Licen!A Hol
OF FLORIDA S 1- / U C f
COUNTY // L
STATE OF FLO IDA l
OF.
COUNTY OF t� J r1-t y
The ffo Ing Instrumen was cknowkedged�yefore me
�r �S2
The forgoing instrument was acknowledged before me
thlsati day of SF 20�K by
this I day of 201 S by
AC E i I S
r o '�L c]
me of perso7fnaking statement
Name pe making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
_
Type of Identification
Type of Identification
Produced
Produced
Q,
AA 4-4.
(Signatu�rc o'
'�
(Signature of Note State of Florida I
Commission
CATHRINE�jR
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Commission No. MY LOMMISS10t�Sg�9072
ISS NN FF941270
oc EXPIRES:Apr06,2020
fFQ990
EXPIRES December 06. 2019
7-01 c�`OFROP BvLW Tlou BuapetXoWSr&u
REVIEWS
FRONT
ZONING
SUPERVISOR
PLA
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
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REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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Rev.8/2/17