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All APPLICABLE INFO MUST BE CO METED FOR APPLICATION TO BE ACCEPTED
Date: December 4, 2019 Permit Number: 2.00E ` 0-1'2
1
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
PERMIT TYPE:
PROPOSED IMPRQUEMENT LOCATION .
Address: 855 SE Corto Terrace, Port St. Lucie, Florida 34984
Property Tax ID#: 3419-550-0060-000-3 Lot No.9
Site Plan Name:fiver Park Unit 7 Block No. 66
Project Name: Moonsammy Residence
i
DETAILED DESCRIPTION OF WORK _
s
t
Conversion of Existing Carport to Enclosed Garage
CONSTRUCTiO!N INFORMATION• `
Additional work to be performed under this permit—check all that apply: />
Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
7Electric _.Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: '256 Sq. Ft. of First Floor: 1135
Cost of Construction: $ 5,500.00 Utilities: —Sewer _Septic Building Height:
OWNER%LESSEE CONTRACTOR ;_,
Name Keysmer Moonsammy Name:Charles D. Kerns
Address:855 SE Corto Terrace Company:Kerns Construction & Property Management Corp.
City: Port St. Lucie State:_ Address:540 NW University Boulevard, Suite 204
Zip Code: 34984 �. Fax: City: Port St. Lucie State:FL
Phone No.772-528-2441 Zip Code: 34986 Fax: 772-209-7700!I
E-Mail:keysmer@bellsouth.iiet Phone No 772-985-5015
Fill in fee simple Title Holder on next page(if different E-Mail kems02@att.net
from the Owner listed above) State or County License 27133
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 CONSTRU.CTIONIIEN LAWN INFORMATION.
DESIGNER/ENGINEER _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:J.Scott Baruch&Associates,Uic• Name:
Address:178 Beacon Lane Address:
City: Jupiter State: Florida City: State:'!
Zip: Phone es,ass 224 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."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contra ctor/Licen J der
STATE OF FLORIDA STATE OF FLORIDA r�
COUNTY OF COUNTY OFSAINTLuciE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of .20_ by this 21 day of Aa!Ei. .20 2Ny
.6. a�Ju-.-S
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification.
Type of Identification Type of Identification
Produced Produced
'r
(Signature of Notary Public-State of Florida) (Si
ry Pulft Stab of F)nds = _
Commission No. (Seal) C so 1° Gufml°r (Seal)
�a 74 -
Fires�orov2osa '
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE ' ' MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19