HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE IFOM ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
i
Building Permit Application JUL 2 9 2016
Planning and Development Services Pub:ic °,,VS.,;:(s
Building and Code Regulation Division St. Lucie Coun'y, Fl_
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: Mile Lake Village Condominium Assn., 12600 Harbour Ridge Blvd., Palm City, FL 34990
Legal Description: Mile Lake Village Condominium, Building 1, Units 1 -8, 13202- 13216
Property Tax ID#: 4426-801-0001-000-6 Harbour Ridge Blvd., Palm City, FL 34990 Lot No.
Site Plan Name: Block No.
Project Name: Mile Lake COA
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace all windows in each of the 8 units
CONSTRUCTION INFORMATION:',
Additional work to be erformed under this permit—check all appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric ❑Plumbing Sprinklers ❑Generator Roof
Total Sq. Ft of Construct'__. S Ft. of First Floor:
Cost of Construction:$ 0 � Utilities:Sewer ElSeptic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name Mile Lake COA Name: Steve Rubin
Address:12600 Harbour Ridge Blvd. _.. _ Company: Rubin Custom Homes
City: Palm City State:FL Address: 4253 High Meadows Ave.
Zip Code: 34990 Fax.772-336-1469 City: Palm City State:FL
Phone No.772-336-3000 Zip Code: 34990 Fax:
E-Mail:P•epperson@hrycc.org Phone No. 561-222-1392
Fill in fee simple Title Holder on next page(if different E-Mail: reception1.rubincustomhomes@gmail.com
from the Owner listed above) State or County License: CGC1518190
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. KY
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: X 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.
s
_Sid t re ofWer/Lessee/Agent gnature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St.Lucie COUNTY OF St.Lucie
The forgoing instrumentrr was acknowledged before me The forgoing instent was acknowledged before me
this�day of \A U" 20 Eby this � clay of 20 W_by
(Name of person acknowledging) (Nam rs acknowledging)
t
(Signature of N tary Public-State of Florida) (Signature of No ary Public-S t of Florida)
Personally Known�OR Produced Identification Personally Known V/ OR Produced Identification
Type of Identification Produced Type of Identificatio
SHERRI KELLEY
Commission No. N.k`b"l ss-ie No. e' R- OMMIS9�14`EE225005
Puy Pli• 7ab
A.SAUNTER �,,
tate of Florida '� EXPIRES October 04,2016
s pires Jan 3 .2 Revised 07/15/2014 n #EE 861169`� National Notary Assn..
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