HomeMy WebLinkAboutBUILDING APPLICATION PACKETAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date,
Permit Number:
Feet IF_
;_--
a s
i i
i ion
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
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: our' 1dqe, @vcl Q,
m ei `iJ, PL.- 314q9
Property Tax ID #: L%26-510 ®00(a - 000 ®I
Lot No.
Site Plan Name:
Block No.
Project Name: mid'
DETAILED DESCRIPTION OF WORK.'
RBI 1,6 W ndaAJ.s J- do�� S�Ze
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CONSTRUCTION 'INFORMATION:
Additional work to be performed under this permit — check
all that apply:
Mechanical GTk Gas Pi ing ecasan
— — — P
-Shutters v/ Windows/Doors
- Electric — Plumbing _ Sprinklers
— Generator Roof
Pitch
Total Sq. Ft of Construction.
Sq. Ft. of First Floor:
Cost of Construction. $ 00 Utilities: — Sewer — Septic Building Height:
OWNER/LESSEE:'
CONTRACTfJR.
Name VOC.Atits) %Z irn i"r"
Name. b
Address$ �.TG�QQ 'L�.
City: State: N I
Zip Code: (�77 Fax.
Phone No. 5l(0'660 -�f5loci
E-Mail: \/0LI it(CJi2mo I • ( o
Company: 1� flpme� 0�sePd'r
Address: 2 r PACI2G(
City: 4 a r
Zip Code: `3ei Fax:
Phone No 71 q "Zoly
State.
Fill in fee simple Title Holder on next page ( if different
E-Mail 1e6 ty5e& cbWo��n;t•c
from the Owner listed above)
State or County License �22%t 7
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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIPA
STATE OF FLO A
COUNTY OF :>` v LuCA -f�
COUNTY OF L to L UCt4C�*
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this,E. day of �' �- , 20_ by
this day of s'/Vsv,r , 20ax- by
Name of person making statement. ti cv
NORSEMEN
Name of person making statement. 2 W1
0 F�, N
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C..) C)
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Personally Known .,� OR Produced Identificat'nO
Personally Known OR Produced Identificati$ng l, M
Type of Identification N
Type of Identification
Produced C 0 0
Produced a
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(Signature of Notary Public- State of Florida)
(Signature otary Public- State of Florida)
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Commission No. '� ✓� �� (Seal) ��� ®��
f
Commission No. �� �� (Sea1) ` c�1� 1
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7 1
14q�7'l— � °� PC—&oc000n c4�e� 00000j
JOSEPH E. SMITH, CLERK OF _ COURT
�•�fL '._'.�S• • r 1, s :.-�uc� �•
Nvos
NOTICE OF COMMENCEMENT
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t. DtLSCRIt°170N OF TROt?ERTY {Legel dcaaiptioo of the pmpesty & atrxt •ddrab if >ivailibk) TAX FOL10N0.: u�iab-b10 -'e901 �f'(.X�D 5
SUBDIVISION, (2JW.JGde, V1IIget� BLOCK TRACT L.OT BLDC ufvrr �
1, GENERAL AE9CRIPTION aF ait'ROYIEMENT; , , t
3. OVYNiVR IIIPORMATIOTt oR LESSEE INFORMATION IF Tim LBS56E CONTRACTED FOR Ttlit IIK2ROVBMENTt
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Stata of
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'Ibe foregoing ulgaumeot y/•s acioaowledged before me this _�_ day of !�7.P-�' ,20,E
by �rl-irh % ► -+ � art •.•s•.-r f T
for
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Notary Pstbns Mate oi.Fbdd!
piul Euperie'staN
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{Stpu tare of Notary Public)
(prjmk Type, ar Stamp Commimcined Name of Notary Pubtie)
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of License #'s -For the most current listing www.Homedepot.com/LicenseNumbers
FL: EC00014401 CGC1514813, CRC046858, CAC1813767, CFC1426021, CFC1427642, 22640, CAC 1818831, CCC1331113,
CCC1331130
Paul Stahl
Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/
or service the equipment listed below at the price, terms and conditions as outlined on this form.
Zammit VAI F1-10 t. Lauderdale CQNVH4
Customer Last Name Customer First Name Store # / Branch Name Customer Lead/ PO#
12478 Harbour Ridge Boulevard
Customer Address
= 1 [(516) 660-5109
Home Phone# Work Phone# Cell Phone#
Palm City FL 34990
City
valzammit@aol.com
Customer Email Address
State Zip
NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY
OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT:
6500 NW 12th Ave, Suite 110 1 Ft. Lauderdale 1 FL 33309
Address City State Zip
Or Email:
customercancellationsouth@homedepot.com
Service Provider Email Address
BY MIDNIGHT ON THE THIRD BUSINESS DAY ACTMO SIGNING, UNLESS THE STATE
SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD, THE STATE SUPPLEMENT
CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE.
YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME
DEPOT'S RECEIPT OF YOUR NOTICE, YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME
DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE
SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED
TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN
SHIPMENT AT HOME DEPOT'S EXPENSE.
AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL.
Acknowledged by:
Contract Price:
Sales Tax:
05/06/2020
Customer's Signature Date
yment Schedule : Payment of the Contract Price is due upon signing unless a
yule is required by law, specified below or in a payment addendum.
$ '3203900
Includes all applicable taxes. Excludes finance charges.*
(If applicable)
��aximum deposit C?NLYappCicable its MD,MA,ME (33 NJ, 1 (99%)
Dep. 25.0 % Deposit Amount it 20800.75 Remaining Balance $ 62402.25
The Home Depot - 2455 Paces Ferry Road, N.W. Bldg. B-3, Atlanta, Georgia 30339 - Customer Care: 1-800466-3337
160 Fl HDE Customer Agreement (24 Jul. 18) Generated Date n r Lead/PO# 1-'l n r (l Nr N a v 0.1.11