HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONEPTED
ALL-APPLIGABBCOMPLETED
J�Permit
INFO MUST BE COMPLET D FOR APPLICATION TO BE CNumber:
Date:.1I • I I • IQ
—r— � SCANNED
BY =RECEIVEDSt. Lucie County
Building Permit ApplicationPlanning 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: Renovation III
Address: 12354 Harbour Ridge Blvd 3-5, Palm City, FL 34990
Legal Description: South Shore Village Unit 3-5
PropertyTax ID #: 4426-807-0021-000-0
Site Plan Name: Cook Residence
Project Name: Cook Residence
Setbacks Front Back: _
DESCRIPTION OF WORK:
Right Side: Left Side:
Lot No.
Block No.
Interior Condo Renovation and Lani Enclosure. Change out A/C 16 seer 2.5 ton American Standard
System , 4 - HR710 Windows, 1 set of SGD 770 in rear Ian!, 1 Front Entry and 1 - AR720. All per plan
and product approvals. Man J & Energy Calcs included.
CONSTRUCTION INFORMATION:
rtiona wor to e erformied under tispermit—check all that apply:
Z✓ HVAC Gas Tank DGas Piping _ Shutters Q Windows/Doors
ZElectric Plumbing [:]Sprinklers 0 Generator EIRoof Roof pitch
Total Sq. Ft of Construction: S� of First Floor: 1,680
Cost of Construction: $ 238,000 Utilities: Sewer 0 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Michael & Holly Cook
Name: Steve Rubin
Address: 537 Mast Drive
Company: Rubin Custom Homes, LLC
City: Bradenton State: FL
Zip Code: 34208 Fax:
Phone No.941-896-5624
Address: 4253 SW High Meadows Ave
City: Palm City State: FL
Zip Code: 34990 Fax: 866-480-7498
Phone No. 772-283-0553 Ext #2
E-Mail: mcook1956@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: reception1.rubincustomhomes@gmail.com
State or County License: ,CGC1518190
If value of construction is $2500 or more, a RECORDED Notice of Comfoencement is required.
J/�
SUPPfEIQENTA_L CONSTIRRU16N
LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
C) -V
MORTGAGE COMPANY: _ of Applicable
me:
Address:
ddress:
City: C
Zip:33ylPhone:
State:
11
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
Name:
of Applicable
BONDING COMPANY: _ of 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 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
Signature ner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFCOUNTY OF
The for oing instrum nt was acknowledged before me The forgoing instru nt was acknowledged before me
thisxdayof v✓ 20 /fby this L2day of 20 /?—by
Personally Known �.,� OR Prod ced denjfiicatiion.��/
Type of Identifica on 8rt1 1- J %f��er�c
Commission No.
Revised 07/15/2014
SRERRIKELLEy
(Name of person acknowledging)
_VWV& "-�
(Signature o Notary Public- Sta of Florida )
Type of
OR Produced Identification
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS