HomeMy WebLinkAbout12060 RiverBend Permit Application it
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10.16.20 Permit Number:
` °` Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
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Address: 12060 Riverbend Rd Port St Lucie FL 34984
Property Tax ID#: 4422.502.0015.000.7 Lot No. 11
Site Plan Name: Block No.
Project Name: Carlson Residence
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Remove existing windows and exterior doors and replace with new impact glass
New Electrical Meter n/a Second Electrical Meter n/a
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Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank Gas Piping Shutters X Windows/Doors _Pond
_Electric _Plumbing Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 60,000.00 Utilities: _Sewer _Septic Building Height:
Name N Name: Michael David Wells
Addre Company: Wells Brothers Construction Co Inc
City: ocic State:_I_ L Address: 9600 SW Citrus Blvd
Zip Code: Fax: _ City: Palm City State: FL
Phone No. - Zip Code: 34990 Fax: 772220.7831
E-Mail: (,- d Q�rSrQ(/` ll� l.lc� hone No 772220.6001
Fill in fee simple Title Holder on next page(if different E-Mail Brandi.m@wellsbrothersconstruction.net
from the Owner listed above) State or County License CGC1506154
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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.
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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 additio
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to -ofih non- i ential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement m result in p y' wice for
improvements to your property. A Notice of Commencement mu '6e recorded i public records of St.
Lucie County and posted on the jobsite before the first inspectio . Ifyou inten o t Fn financing, consult
with lender or an attorney before commencing work or recordi 9wour Notic of C encement.
SignAufe ol Owner/Lessee/Contractor as Agent for Owner Si=arntra r/ ' e s Holder
STATE OF FLORID( SFL RIDA
COUNTY OF_LJ LI,ICI� COUNTY OF kif f IJ
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
P ysical P c or Online Notarization Physical Presence or Online Notariza
this day o 2020 by this day of 2020 by Z
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Name of bersonimaking statement. Name of person making statement. z
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Personally Known `�' OR Produced Identification Personally Known 1P OR Produced Identific'tionO -°
Type of Identification Type of Identification 23
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Pr uc Produced a X
B AN MURCHIS N
i ure of Notary Pub - ie Frort&t OMMISSION#GGO 1 O nnature of Notary Public-State of Florida)
EXPIRES January 08,2 21 ``'' ((''
a `Commission NoG�i Seal ,�•� mission No. b51436 (Seal) -;��,•,yst�.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5