HomeMy WebLinkAboutPermit App.Schmitt@Poinciana.notarized (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04/06120 Permit Number:
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 Y
PERMITTYPE:SLAB
PROPOSED IMPROVEMENT LOCATION:
Address: 9504 POINCIANA CT., FT. PIERCE, FL 34951
Property Tax ID #: 1334-502-0075-000-6 Lot No.194
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
FORM & POUR CONCRETE SLAB, 4" THICK, NO FUTURE STRUCTURE, 3000 PSI FIBERMESH
CONSTRUCTION INFORMATION:
Additional work to be 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: 120 Sq. Ft. of First Floor:
Cost of Construction: $ 2200.00 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name h Y Anw( `-�-VACt i-V
Name: PAUL KUHN i
Address: �1`� C` i 1��,iY1LI� ��« .�.
Company: HERITAGE CONTRACTING SERVICES, INC.
City: ` i- State: '% L-
Zip Code: b'-t `) 5 1 Fax:
Address:4900 CONLEY PL
City: FORT PIERCE State: FL
Phone No. i - �2,4 - '5 C5
Zip Code: 34951 Fax: N/A
E-Mail: fir,( � f S A (' 0,D1 - C-1c, M
Phone No 772-216-6612
Fill in fee simple Title Holder on next page ( if different
E-Mail PAUL.K.HCS@GMAIL.COM
State or County License CGC1507158
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,50D 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
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
_Not Applicable
V YY1YCr%/ l.Uly I KAL I UK Att•IUVI I: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no y work or installation has commenced prior to the issuance of a permit.
which is inoconflictawith anes no y applicableion HomeaOwis ners Associnting a ation ruleswill aby bylaws or and covenants thlder at mayldrestrictbor prohib t 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 T 1OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR qN ATTORNEY BEFORE RECORDING YOyR2qDCE OF MENCFMW
Signature of Owner/ Lessee/Contractor as Agent for Owner i Signa ure of
Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _"�4 • W6 e_ COUNTY OF + Utc i L
The forgoing instrument was acknowledged before me
this 6 dayof_rt1b 202_Q by
Pcm l Ku hr1
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
The f�o�r�oing instrument as acknowledged before me
this sL day of A3 '(l 20 ZD by
'Pain Ku-6
Name of person making statement.
Personally Known V/ OR Produced Identification
Type of Identification
Produced
Je k) GVI/1V c u'&)
(Signature of Notary Public- State of Florida) (Signature 9f NntaDA PiiKlir_ sfarP of Fin,ma i
«^" CONNIE CHILDS
CONNIF CHILOSI) Commissio ; ��Q89I,
27619
ISSION Ar
c MY COMMISSION # GG127619 '�:�•.. EXPIRES Au ust 31. 2021
---EXPIRES -ugusf 31. 2i521 u
PERVISOR PLANS A TURTLE] —MANGROVE
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