HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO M LIST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
•
UANNY El]
D' ate Permit Number:
B
1-lide County
RECEIVED
Building Permit Application
SEP 0 6 7019
Planning and Development Services
Permitting DePartment
Building and Code Regulation Division
St Lucie4CoUnty
2300 Virginia Avenue, Fort Pierce FL 1 34982
Phone: (772) 462'15S3 Fak:'(772) 462-1578 Commercial X Residential
PERMIT=APPLICATION FOR: Alteration
PROPQSED IMPROVEMENT LOCATION:
Address: 3,_
Legal Description: DU I FW"NWCD3 OF einocs MOIINIE V40IIM D%INJNE3m 7MA TOW AJWLIUS 1,THS MOTO. 21 MIN USIECECUMPI
IM.1HN 4021 ITUI OSIOINI
Prope�ty Tax ib #: 14064130603 0008.w
Lot No. i
Site Plan Name:
Block No.
Project Name: INDRIO w
Setbacks Front Back: Right Side: Left Side:
IPETAILED DESCRIPTION OF,WQRK*
CbNSTRUJqTk9'N INFORMATION: III
LJHVAC Gas lank
ZEIectflc Plumbing
Total Sq. Ft of Construction:
Cost of Construction:.$. 4500
Lsh.tters ElWindows/I []Gas. Pipi n.
[]Sprinklers 11 Generator 0 Roof Roof pitch
S Ft., of First Floor:
ptilitim Sewer Septic Building He-g fij:480'.
OWNER/LESSEE:
CONTRACTOR:
NI
Name: STANLEY MACLIN
-Addr M ess: 8601 WEST SUNRISE BLVD
Company' Mastec Network Solutions
City: MIRAMAR State: FL
Zip Code: 33222 Fax:
Phone No. 954 809 4449
Address: 61.00 BROKEN, SOUND PKWY.-
City: BOCA RATON . State. FL
33487
Zip Code. Fax:
Phone No. 561-962-9822
E-Mail: ROREY.WANLISS@MASTEC.COM
Fill In fee simple Title Holder on next page (if different
from the dwrier listed above)
E-Mail: ROREY.WANLISS@MASTtC.COM,
State orCounty License: CGC1515769
If value of construction -is $2500 or more, a RECORDED Notice -of Comm6ficement is requirid
SUPPtEMENTALCONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: AT&T
MORTGAGE COMPANY: _ Not Applicable
Name: STANLEY MAOLIN
Add tress: 3400 LAKESIDE DRIVE
Address: 8601 WEST SUNRISE BLVD
City: MIRAMAR State: FL
Zip: Phone
City: BOCARATON State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Mary Jane Spain
BONDING COMPANY: _Not Applicable
Name: N/A
Ad dress: 6100 BROKEN SOUND PKWY
Address:
City: Tupelo, MS
City:
Zip: 38802 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, bylawsor 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 your Notice of Commencement.
'Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Co ractor/License Holder
STATE OF FLO
STATE OF FLO IpA
COUNTY OF Jr, UGiIJ
COUNTY OF {,
The forgoing instrument was acknowledged before me
The for oing instrument was acknowledged before me
I-()L(U
this � day ofl 9 , 2019 by
this day of . 20A9 by
1acl.2s—t � K2\ ' ���
S%/l. "_ %Wc%./
Name of person making statement
'o
a of person making statement
Personally Known OR P
Personally Known P c I e t' i
Type ofldentification .1� Notary Public Slate of Mors
Produced
Type of Identification • NoreryPublicStateofFl
Produced 1: Raphaella L DO Paula
+Q la L De Paula
a My Commission GG 322520
Exix W1112023
p Ex Commission 23 32252
' 9i � Expire1041112023
�wds`
(Signature of NotaryPublic- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. G�1322520 (Seal)
Commission No.66a2252-0 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
1
COMPLETED
Rev.8/2/17 ( V