HomeMy WebLinkAboutPermit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
------Permit Number:--'---��---
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
Commercial ftesidential x 2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 --------
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 6603 South Indian River Drive
Property Tax ID#: 3412:1'41-0002-0002 ,• Lot No. ___ _
Site Plan Name: __________________________ _ Block No. __ _
Project Name:------------------------------------
I DETAICED DESCRIPTION OF WORK:
Install stone veneer on Southside of home and aluminum siding on front and rear of home
I 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: _6_40 ______ _Sq. Ft. of First Floor: _________ _
Cost of Construction:$ 240 0 ---------Utilities: Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:· � CONTRACTOR: ... -
Name Kenneth Wortenberg Name: Chris Quinn
Address:5 7918 NW 15th Street company:Luxury Renovations & Additions
City: Miami Lakes State: Address:640 SE Monteiro Drive
Zip Code: 33014
Phone No. 305-527-5858
E-Mail: kwcpa@acpas.com
Fax:
Fill in fee simple Title Holder on next page ( if different
City: Port Saint Lucie
Zip Code: 34984
Phone No561-719-9709
E-Mail info@luxreno.org
Fax:
from the Owner listed above) State or County LicenseCGC1523559
If v;ilue 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.
. '
.,
State:�
April 29, 2020
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address: Address:
City: State: City: Slate:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR( NOTICE OF COM ENCEMENT."
,,-
,
Signatur of Owner/ Lessee/Cont ctor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Martin County
Signature of Contractor/License Hol er
STATE-OF FLORIDA
COUNTY OF Martin County
The forgoing instr ment was acknowledged before me
this 6 -r--clay of'. , 20 Et) by
The forgoing instr ent was acknowledged before me
this /2„6---day of ) •—r..exti,ty , 207-0 by
Name of person making statement.
Personally Known OR Produced Identification x
Name of person making statement.
Personally Known OR Produced Identification
Type of Iden Ication i
Produced VA e(z S 1-,'(- ee:4-,
Type of !de ica nri,... .
Produced 'LI da,= ve, et,Ls .464,se.-_
/ --/
(Signature , Nota y Public- State of Florida)
Commission No•GC/ 0 I i <5.-) °7 Nuf,0ealporlene Ediund-Che,)Commission
(Signature of N tar Public- State of Florida)
„. ,.. (-~ne, A Koriene Edlund-Chan No(iCtC)/ I ") i /
°kV -4Y-NOTARY — ''' OTARY PUBLIC
--I STATE OF FLORIDA -)ts N
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.,*.Q ex )STATE OF FLORIOA
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DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19