HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/29/16 Permit Number: lei
s `w_ RECEWED
Building Permit Application AUG 0 8 2096
Planning and Development Services
PERMITTING
Building and Code Regulation Division
St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential YES
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Chung
PROPOSED IMPROVEMENT LOCATION:
Address: 121 SE SERENATA CT PORT ST LUCIE FL 34983
Legal Description: RIVER PARK-UNIT 5 BLK 46 LOT 21 (MAP 34/28N)(OR 3892-66)
Property Tax ID#: 3419-540-0125-000-6 Lot No.21
Site Plan Name: Block No. 46
Project Name: GORDON
Setbacks Front Back: Right Side: Left Side:
f
DETAILED DESCRIPTION OF WORK:
TEAR OFF SHINGLE ROOF AND INSTALL NEW SHINGLE ROOF (4/12)
CONSTRUCTION INFORMATION:
Additional work toe e orme under t -checkispermit a appy:
❑HVAC 11 Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers ❑Generator Roof
Total Sq. Ft of Construction:
0 L/b S . Ft.of First Floor:
Cost of Construction.$ Ll y 0n,M Utilities:CnSewer 0 Septic Building Height: S r
OWNER/LESSEE: CONTRACTOR:
Name 613 Homes LLC Name:
Address:P O Box 3047 Company:
City: MIAMI BEACH State:FL Address: n02 liC� T�wL
Zip Code: 33140 Fax: City:)Q� , rt _PACJG _State: L
Phone No.305-761-.4535 Zip Code: Fax: 77!,-?-Utvy o1oQ0
E-Mail: Phone No. 2 72^ Ll Lo L4- L 900
Fill in fee simple Title Holder on next page(if different E-Mail: Q 0 11 2=F4n c —8 ,
from the Owner listed above) State or County License:
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 thepermit 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 rk or recording our Nqtice f Commencement.
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Signatilreof Owner/Lessee/Agent Signature of Contractor/Licen older
STATE OF FLORIDASTATE OF FLORIDA '
COUNTY OF 6) 11 �- 1�,����, COUNTY OF L(
The forgoing instru ent was acknowledged before me The forgoing instr ent was acknowledged before me
this aolday of 20 1*by this t day of 20 by
(Name of erson acknowledging) (Name person acknowledging)
r
r
(Signature of Notary Pu li�c-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known �/ OR Produced Identification Personally Known I OR Produced Identification
Type of Identification Produced Type of Identification Produced/I I
Commission No 00 / (Seal) Commission No. � �/r p
(Seal)
ao��...Mae, FAITH MASON
ot►g;;��� FAITH MASON , * My COMMISSION#GG 003939
* * MY COMMISSION#GG 003939 110%6T `oe EXPIRES.June 20,2020
Revised 07/15/2014 "� V EXPIRI:S:June 20,2020 '�oR��o�, eandedit wd9elNafaySjMm
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS