HomeMy WebLinkAboutBuilding Permit Application RECEIVED JUN12.5 1015
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Date: �v Permit Number: I��"(31 S 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 Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
v
PROPOSED'!
MPROVEM ENT LOCATION,:
Address: 217 SE Camino cr Port Saint Lucie.FT. 34952
Legal Description: River Park unit 3 Blk 31 Lot 12 (Map 34/22S) (OR 3684 - 1120: 3712-2306)
Property Tax ID#: 3419-515-0279-000-2 Lot No. 12
Site Plan Name: Block No. 31
Project Name: Roznowski#8353033
Setbacks Front Back: Right Side: Left Side:
ry f,H
DETAILED DESCRhPTION OF 1NORK: J11111-1111111111111 2,
Replace 15 fabric panels.
CONSTRUCTION.INFORMATION:
Additional work toe e Orme un er t is permit—check a appy:
HVAC E] Gas Tank ]Gas Piping _Shutters a Windows/Doors
❑Electric ❑ Plumbing OSprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$3915 Utilities:cn Sewer O Septic Building Height:
OWNER/LESS,Et' .' CONTRACTOR:
Name Daniel Roznowski Name: Boysie Ramdial
Address: 218 SE Camino St. Company: The Home Depot At Home Services
City: Port Saint Lucie State: FL Address: 674 Military Trail
Zip Code: 34952 Fax: City: Deerfield Beach State:FL
Phone No. Zip Code: 33442 Fax:
E-Mail: Phone No. (974)379-1500
Fill in fee simple Title Holder on next page (if different E-Mail:
from the Owner listed above) State or County License: CRC046858
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL-:CONSTRUCTION LIEN LAW INFORMATION."'-
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:' Name:
Address: . Address:
City: State: City: State:
Zip:, Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: . _Not Applicable BONDING COMPANY: Not Applicable
Name: 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
commencing work or recording our Notice of Commencement.
Lai
Signature of Owne /Agent/Lessee Signa ut re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this zZ day of SvU� 20 15 by this 2Z day of Jc�WE ,20�by
�D`15I F-- 74A.AD,A L.
(Name of person acknowledging) (Name of person acknowledging)
nature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR.Rroduced Identification
Type of Identification Produced Type of Identification Produged
Commission No. (Seal) Commission No. (Seal)
\ Edek Do Dios
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;NOTARY PUB
NOTARYPUSUCLIC''
Revised 07/15/2014STAT ;OF FLORIDA o STATE'OF FLORIDA
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REVIEWS FRONT. ZO G.: (4Lli� R�: PLANS VEGETATION. SEA TURTL11 E MANGROVE
COUNTER REVIEW ` 'REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS