HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Gt ' �Y.'A�C; Permit Number: 6-5 O-V-Z • 0
Building Permit Appli
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Planning and Development Services
Permitting
Building and Code Regulation Division e2300Virginia Avenue, Fort Pierce FL34982 LucCounty, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE: Interior Remodel
PROPOSEDIMPROVEMENT•LOCATION:
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Address: 13206 Harbour Ridge Blvd.3A
Property Tax ID #: 4426-801-0003-0000
Lot No.
Site Plan Name:
Block No.
Project Name:
;.• ,•,
DETAILEDeDESCRIPTION'OFWQRK:71
Remodeling- New kitchen, relocate sink, replace 1 sliding glass door and re -frame opening.
New trim, new paint and flooring.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
XElectric Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 70,000 Utilities: —Sewer _Septic
Windows/Doors
_ Roof Pitch
Building Height:
OWNE%ESSEE:
°CONTRACTOR 4x rk F.. _, -
Name Timothy Dagg
Name: Rick Adams
Address:287 SE Calmo Cir.
Company, RA Construction of The TC
City: Port St. Lucie State: E.
Zip Code: 34984 Fax:
Phone No.
Address: 2165 NE Ocapi Ct
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No 772-260-8419
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail racon4@comcast.net
State or County License CGC1520713
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.
SIIJPPL16EM,ENTAL G* NSTRl4 � •ION LIEN
LAW 1NFORM4TION:11,0111
DESIGNER/ENGINEER: x
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State: _
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 LENPM OR AN ATTORNEY BEFORE RECORDING UR NOTICE OF COMM EMENT."
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Signature Owner/ Lessee/C ctor as Agent for Owner
Signature of Contract icense Holder
STATE OF FL
STATE OF
COUNTY OFORIDA �(4(n
COUNTY OFORIDAnn( ��/,�
The forgoing instru ent was acknowledged before me
The forggo�ing instrument was acknowledged before me
this, dJ ( th 2W by
this ai day of / 20Z by
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Name of person maki tement.
Name of person making statement.
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Persc ially Known OR Produced Identification
Personally Known OR Produced Identification
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T'� f Identification
Type of Identification
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P4b ced
Produced
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ture of Notary Public -State of Florida
otary Public -State of Florida <J
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Commission No. ERVI%5a (Seal)
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