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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Cad Permit Number: 0 ��11 _ RECEIVED � FEB 19 2020 Building Permit Applicata 'ST. Lucie County, Permitting 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�wa Residential Q PERMITTYPE: QJ PROPOSED IMPROVEMENT LOCATE Address: 10410 S.ocean Dr Apt 903 jensen Beach FI 34957 Property Tax ID#: }�j y • ®Q(0 (0 ' ©0• Lot No. Site Plan Name: Block No. Project Name:lRichard P Mihaljevic DETAILED DESCRIPTION OF WORK: install new shower pan in and new shower valve CONSTRUCTION Additional work to be performed under this permit–check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electriclumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$1900.00 Utilities: —Sewer —Septic Building Height: OWNER/LESSEE ; CONTRACTOR R r. ._ Name Richard P Khaijevic I Name:Robert Powers Address:10410 S.Ocean Dr Apt 903 Compan :Powers plumbing Corp City:liensen Beach State:_ Address:3098 s.w.Virginia Av Zip Code: 34957 Fax: City: Palm City State:FI Phone No.585 315 6870 Zip Code: 34990 Fax: E-Mail: Phone No561 7567727 Fill in fee simple Title Holder on next page(if different E-MailIRpplumbing33@gmaii.com from the Owner listed above) State or County LicenseCFC21429104 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 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: 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,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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEND ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDASTATE OF FLORIDA COUNTY OF �, LyG(E COUNTY OF The fo oing instru t as acknowledged before me The for oing instru eq as acknowledged before me this. day of 20 bby this day of 20�by Name o person making statement. e Namof person making statement. / Personally Known OR Produced Identification ✓/ Personally Known OR Produced Identification V Type of ldentifica#on Type of IdentificiWon c� Produced t' L L Produced (Signature of NotaUrublic--trke of Florida Y (Signature pYP �i� KAREN S. NI S N ;1pPY PVB,, KAREN S. NIELSEN Commission 90`° °�. ,Pya , Commissio �gState of Florida-Notar(�@0})ic _* rida-No blic p Commission GG 207484 v; ommission # GG 2 7484 ;� P,V o: ',;rF oa My Commission Expires M Commissicn Ex iras oFFv," June 12, 2024 june 12, 2822 REVIEWS 9ERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. /7119 RECEIVED C U tl I 7 2020 S1 Wde County, Permitting FLORIDA INDIVIDUAL ACKNOWLEDGMENT F.S. 117.05(13) — Effective January 1, 2020 State of Florida County of T_l The foregoing instrument was acknowledged before me by means of Physical Presence, —OR— ❑Online Notarization, this day of 29.20 by Date Month Year me of Person Acknowledging Ec DARRYN J.NINE Notary Pu61ic State of Florida Signature of otary ublic—State of Florida � Commission#GG 918337 My Comm.Expires Oct 31,1013 J Name of N tory Typed, Printed or Stamped ❑Personally known bl roduced Identification Type of Identification Produced: Place Notary Seal Stamp AboveC� .S OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: 02 1 Number of Pages: Signer(s) Other.Than Named Above: /`I/✓�'/ 02019 National Notary Association M1304-11 (01/20)