HomeMy WebLinkAboutTUCKER PERMIT AND NOCAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (Permit Number:
O �
Building Permit Application
Planning and Development Services
Building and Code Regulotion Division Commercial Residential
2300 Virginia Avenue, Fort Piero FL 34982
Phone: (772) 462-1553 Fax: (�72) 462-1S78
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: `-� L(_- �' � � ( " 1
Property Tax ID#: ��laa- Soo-OOa�
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
0
New Electrical Meter Second Electrical Meter �I
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that Opply:
_Mechanical Gas Tank _ Gas Piping _Shitters _ Windows/Doors
Electric Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction: Sq. Ft. o First Floor:
Cost of Construction: $ e) v Utilities: _ S wer , Septic
Lot No.
Block No.
Building Height:
Pond
Pitch
OWNER/LESSEE: CONT ACTOR:
Name Ct Name:
Address: I vl i, ( Company: S L_
City: �LA � Lug �� State:- Address: u �
Zip Code: Fax: City: State,
Phone No. c Q C,Zip Co : TI— Fax:
E-Mail: Phone o
Fill in fee simple Title Holder on next page j if different E-Mail cY ' J
from the Owner listed above) State 4 County License N 2
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
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, bylawis 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 1 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 oncurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and ccessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or reco in r Notice of Com//mencement.
/
"I ~ f /
ignatu of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF W,,_ ,L' ,'t
Signature of Contractor.
r
STATE OF
COUNTY OFORIDA
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Sworn to
Phy
or affirmed) and subscribed before me of
icai Press ce or Online Notarization
this 1N1 day of 2020 by
this
�-day
of
2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification Y
Personally Known _ ,� OR Produced Identification
Type of Idenfication {}
Type of Identification
Produced AYA (2k (
Produced
ll _ 11
ignatdre of Notary P
(Signs r 4 Notary Public-
'
ate of Florida )
Commission No.�9G l _.
CHRISTINE YO'N
"; Notary P I'[ tateofRorida
q
Commission No. ��
Ca S GG g7p2g
R.� (Seal)
f CHMSTINEYOW
p�„�
;L N1y Comm. Expires A r 28, 2422
, Notary Public - State of Flarid
.
hr h Natgona4 Notar Assn_
q e Commission -
' GG 581029
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
Bonded(
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roa h National Notary A .
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
NOTICE OF COMMENCiEMENT
Permit No.
State of Florida, County of St. Lucie
Property Tox ID No. 3422-500-0029-000-9
The Undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided ini this Notice of Commencement.
Legal Description of property and address if available VISTA ST LUCIE BLDG 3 UNIT 101
General description of improvements INSTALLING A MOEN POSITMEP MIXING VALVE EMOVING TUB ANO INSTALLING AN ACRYLIC SHOWER BASE
Owner/lessee BYLVIA TUCKER
Address 3 LAKE VISTA TRAIL, UNIT 101, PORT SAINT LUCIE, FL 349;
Interest in property:
Fee Simple Title holder (if other than owner)
Address
Contractor BATH FITTER SOITH FL LLC.
Address 2701 VISTA PKWY, A3, WEST PALM BEACH, FL 33411
Surety
Address
Amount of Bond
Lender
Address
Phone# 561-333-3101
Fax # 561-689-2815
Phone #
Fax #
Phone #
Fax #
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
by Section 713.13 (a) 7.7 Florida Statues;
Name Phone #
Address
In addition to himself, owner designates
Phone #
Fax #
Fax #
of
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to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes. Expiration date of notice of
commencement is one year from the date of recording unless a different date is specified. WARNING TO OWNER:
ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTE�f E OF COMMENCEMENT ARE CONSIDERED IMPROPER
PAYMENTS UNDER CH.713.13, F,S., AND CAN 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
COMMENCMENT.
J L 4 � `7 Ai
or Owner's or
Signatory's Title/Office
State of Florida, County of " 4
Acknowledged before me this -ls' , day of
who is p rsonally known to me who has produced Ij
U
Signature of Notary Type or Print Name
Title: Notary Public Commission Number
WORK OR RECORDING YOUR NOTICE OF
Authorized
by
Signature
as identification.
`rotary Sal
,�� cr •.. CHRISTINEYOW
No,ary Public - State of Florida
Car+rs�ss�an,GG'87029
S;y Cemm, Exp;res Apr 28. 2022
,.......BOnded th700CH-NA-,0na3 Natary Assn.