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HomeMy WebLinkAboutBuilding Permit Application, ORIGINAL, with contractorAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: October 26, 2020 P L t U© t ----- Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Residential xxxx PERMIT APPLICATION FOR: Addition to existing 2 story residence PROPOSED IMPROVEMENT LOCATION: Address: 12772 NW Mariner Court, Palm City Property Tax ID #: 4425-603-0010-000-1 Site Plan Name: Klein Project Name: Klein Addition DETAILED DESCRIPTION OF WORK: Add Staircase, Elevator, 2nd Floor sitting Room and Master Bathroom remodel Lot No. Block No. New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit— check all that apply: _Mechanical _ Gas Tank Gas Piping _ Shutters Windows/Doors _ Pond Electric Plumbing _ Sprinklers _ Generator X Roof Pitch Total Sq. Ft of Construction: 544 Sq. Ft. of First Floor: Cost of Construction: $ 335,000.00 Utilities: —Sewer _ Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Susan Klein Address: 17 Black Birch Lane City: Concord, MA State: _ Zip Code: 01742 Fax: Phone No. Name: Jeffery A Bowers Company: Masterpiece Builders Address: 410 Colorado Avenue City: Stuart State: FL Zip Code: 34994 Fax: 772.283.2770 Phone No 772.283.2096 E-Mail jbowers@masterpiecebuilders.com E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License CGC 048543 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 MORTGAGE COMPANY: xx Not Applicable Name: MA. Corson BAssociates Inc Name: Address: 412 Colorado Avenue Address: City: Stuart State: FL City: State: Zip: 34994 Phone 772223.8227 Zip: Phone: FEE SIMPLE TITLE HOLDER: xx Not Applicable BONDING COMPANY: xx 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 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 recording our Notice of Commencement. (7,4Li� AADQQ St, gAltllre o Owner/ Lessee/Contractor as g nt for O ner Si a v e of Con ractor License Holder STATE OF FLORIDA SATE OF FLORIDA COUNTY OF Martin COUNTY OF Martin Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of xx Physical Presence or Online Notarization this Zd day 2020 by xx Physical Presence,or Online Notarization Z� day of this of 2020 by Jeffery A Bowers / Contractor as Ageny for Owner Jeffery A Bowers / Contractor/License Holder Name of person making statement. Name of person making statement. Personally Known xxx OR Produced Identification Personally Known xxx OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public- t <�?Y?• • "' CYNTHIADJUNING ature of Notary Pu �;, t *fiFkW ISSI0N#GG367784 =w :;' GG367784 �;: ;+ &C0MMISSI0N#GG36 EXPIRES: September 23, 2023 :,oF�;°P' Commission No. 8gO fission No. GG367784 Bow PtibkUnderwters 6 oPP`. IRES: September 23, �" F , Bonded Thru Notary Publbc Und 23 ftm REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.