HomeMy WebLinkAboutLongman Application J„H APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: q Permit Number:
,..
BuildingApplicationPermit
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578 Commercia0 Residential
PERMIT APPLICATION FOR
PROPOSED INPROVEMENT LOCATION1
Address: Q� ` C �(1 t(YNV`L- O(Z:X\jf, i Q
Legal Description:
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Property Tax ID#- 5 a,� - "1 Lot No.
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Site Plan Name: Block No.
Project Name:
Setbacks Front Back: S.aa. Right Side:6-4T Left Side: 8•C,c
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
..._t„ t..E, t........t.... .L......t..,.E..t.....E.. .I
Additional workto e performed under this permit-check all that apply.
Mechanical Gas Tank Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction:(A) b Sq. Ft. of First Floor:
Cost of Construction: 3Doc),&D Utilities: Sewer Se Buildintic$ p g Height:
�JWN E R/LE CONTRACTOR:' E ►`.. `.t �f
Name Name:
-C-S 4RL 1,
Address: Q� L )?I) Company: Ncy., woo*
City: Y1 State: AddressSS:
011:11usallAq
p Code Zip : qVqS'7 Fax: Cit : State:
Y
Phone No. /vf', 0 4 Zip Code: Fax:172-12&—w
E-Mail: �C1 Phone No77c�" l�l�
Fill in fee simple Title Holder on next page if different E-Mail � �C..•C
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from the Owner listed above State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER ENGINEER:
� t. Nat Applicable MoR T GAGE CO ;..,
Name: Name _
PANS'. �r Not Applicable
Address: Address:
City: State: City:
------- State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: � �Jf'� Not Applicable BONDING COMPANY: -
� Nat Applicable
Name Name:
Address:
t Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and ins ll t-. �p to aeon as indicated.
1 certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Count,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 andcovenants
structure.Please consult with your Home Owners Association and review sour deed fora y strict ones which ma or prohibit titbit such
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In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance 1.Atith 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
impious er
efirst
ts to your pro arty.A Notice of Commencement must be recorded and posted on the `absite
before inspectio you intend to obtain financing, consult with lender or an attorney before
cony engin w 'or r ding your Notice of Commencement.
Lure o /'L see/ ntractor as Agent for Owner Sign 4ure of° on tractoryticense Holder
STATE OF FL o I A STATE of FLORIDA
CoUNTYoF `
(N P b I -% Aa:,� COUNTY OF RAE.
The f rgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
g this day of ,20� by this day of ,20 "_ by
IR A- [I
Name of person acknowle n
P g) (Name o ers n cknowledging)
Lila
vim
C/Y�lAell
(signature of No b ic-State of Florida} (Signature of N a Public-State of Florida}
Persona K ow OR Produced Identification Person `n n OR Produced Identification
Type of ent a ion Type o den . ca i n
Produc rY Public State of:Florida Produ �ry PublIc State cf FiorJdA
MY Coanrnlselon GG 1 My Cort�mias;onGG 117Commi 'o 07*6=21 l) Comm' io 07 61'.'(Sea
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. _ -
PJGANNi -�VELt PMENT`SERVICES DEPARTMENT
R, ;_' Building&Code Regulations Division
. 2300 VIRGINIA AVENUE
FORT PIERCE.FL 34982-5652
(772)462-1553
HOLED LAND AFFIDAVIT
1,the undersigned, am the owner of the followhig described property,
1 111
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(Parcel W/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accep ting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D). St.Lucie County Land Development Code,I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
l ftirther acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged ,nor liable to provide for, or maintain m any form,
adequate drahiage off nay property which will not adversely affect the immediate
community.
r erfiy (PI Pr'
"y. Q
operty Oti r i Date
FLORIDA,
STATE OF r ,COUNTY OF
BEFORE ME THIS DAY OF
ACKNOWLEDGED
BY
WHO IS PERSONALLY KNOWN TC)ME __-)OR WHO HAS
PROD CED AS IDENTIFICATION.
GNATURL OF LI TYPE OR PRIM NOTARY
-COMMISSION NUMBER
Notary Public State offtd?
Kin bey Jo Holmes
Few
My Commission GG 117612
Expires 07/26=1
SLCP'DSD Revised 04I1 I42011
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4432373 OR BOOK 4128 PAGE 2687, Recorded 05/07/2018 12:16:27 PM
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.3522 700 0009 000/4
State of Florida County of St.Lucie
The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statutes,
the following information is provided in this Notice of commencement.
Legal Description of Property:(and street address if available): Lc±�17 w(/�t
General descri tion of im ra a t:Fear Patio Ike lace Pavers with Concrete v� �� 4 D �z
mer
R i p v
Owner information or lessee information if the Lessee contracted for the improvement:
Name nqnmpl nnaman
Address 7667 Pelicin Pointe drive, Jensen Beach, FL 34957
Interest in property:QWn .F
Name and address of fee simple titleholder(if different from Owner listed above):
NIA
Contractor's Name:Benchmark III Corporation, Inc. _
Contractor Address:3322 SE Gran Park Way. Stuart, FL 34997 Phone Number:772-329-0205
Surety(if applicable,a copy of the payment bond is attached):Amount of bond:$N/A
Name and address: Phone number:
o Rr ,
Lender Name:N/A Phone Number: 'tom
Lender's address: o
Persons within he State of Florida designated b Owner upon whom notices or other documents may be served as provided b Section '
t g Y p Y P Y �
713.13(l)(a)7.,Florida Statutes:
Name: Benchmark I! orporation Phone Number:772-320-0206
Address:3322 SE Gran Park Way, Stuart, 1=L 34997
In addition to himself or herself,Owner designates of _ to receive a copy of the u- tx 4=
Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. U W
Phone number of person or entity designated by owner: C**4
Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to them ~
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contractor,but will be 1 year from the date of recording unless a different date is specified)
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WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE COW MI JK Q� cn�qcc
IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FC 0 p
IMPROVEMENTS TO YOUR PROPERTY,A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE a
INSPECTION.IF U INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORT(A-6- z <
RECOROIN OUR OTICE OF COMMENCEMENT. LU -...
Unde penalty per clare t I have read the foregoing notice of commencement and that the facts stated therein are true t04r ,b 't 0
my Wed an
( gnature of owne o esse ,or ner`s or Lessee's Authorized Officer/Director/Partner/Manager
Low ki a
(Signato s Title/Office)
The foregoing instrument was acknowledged before me this day a
2 04T,
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By miu, Lbniinlq�) as ow,", _ far [
Na a of Person Type of authority(e.g.officer,trustee) Party on behalf of whom instrument was executed
Personally know or produced Identification
Signature of a ubiu-State of Florida)
(Print,Type,or Stamp Commissioned Name of a of Identification produced
ON ��pt�c Stilts of Fi�oYfde
N OnbwV Jo Holm" T612
41 mY aG 11
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