HomeMy WebLinkAboutBuilding Permit Application (original submitted) All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: . )_, ', ` Permit Number: �2 to J
Building Permit Application
Planning and Development Services.
Building and Cade Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential x
PERMIT TYPE:
77
:GIII'6:1i'rSSJV. 1~iY I,.Ii �,`; Y ,614 � ..' I;I`�E`u��T+�'"
5 � '
Address: 117 QUEEN ELIZABETH'CT,.FT PIERCE, FL 34949
Property Tax ID#: 1414-701-0070-000-7 Lot No.H
Site Plan Name: Block No. 8
-Project.Name:
r
�'~',�t.�'•� � j.`�(�(,t.'ir- O 1• �- 1�-t�-�' L t'1Z Cf� {"�'��•� _
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator ,Roof Pitch
Total Sq. Ft of Construction: Sq.Ft.of.First Floor:
Cost of Construction:$ 5100 0 D Utilities: —Sewer —Septic Building Height:
kC�wN �$. SEE
NameGREG ISBE:LL ame:JOY S YANCY
Address:117.QUEEN ELIZABETH CT Com an SUMMERLIN'S.MARINE CONSTRUCTION,LLC
P y:
City: FT PIERCE State:— Addressc200 NACO.RD, SUITE C
Zip Code: 34949. Fax:N/A Ci FT PIERCE FL ty: . State:
Phone No.561-662-4256 Zip Code: 34946 Fax: 772-464-7470
E-Mail:GREGCATTLEMENSMARKET@GMAIL.COIVI 772-464-6090
Phone No
Fill in fee simple Title Holder On next page(if different E-Mail SUMMERLINSMARINECONSTRUCTION@GMAIL.COM
from the Owner listed above) State or County License?4217
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.
j -
SUPPLEMENTAL CONSTRUCTION LIEN LAW"INFORMA
TION: .
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Oencl- 7markl Name: .
Address: 30 D{ 4 Y--Q
Address: .. .. .
City: G i C-. State: FL City: State:
Zip:3qAJe5 Phone 7-7Q—_fit ,j3 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County anA posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender orAnn attorney before commencing-work or recor ink our Notice of Commencement.
Sig"_,Lufislo-f 0 ,tiff lessee/Contractor as Agent for Owner Signature'df Cbntract /Lic hse Hlblder
STATE OF FLORIDA STATE OF,FLORIDA
COUNTY OF. _S_i COUNTY OF S ;,:.:LIU c.r'=
Swor o(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
Ak
t v3day of-De C_ •2020 by this QQIay of # �C� J 2020 by
9 1 4 j C,,," 1- a
ti
�d . e of person ing statement. Name of person making statement.r o
`�_T sonally Known V OR Produced Identification Personally Known V" OR Produced Identification , tq,1.0
N le
of Identification Type of Identification 0 : .
N uced Produced o-} m U
Vignature of No Public-State of Florida ".
JC0110
(Signature of otary Public-State of Floridamission Now 4 ` �z +
C 3 3C�v (Seal} Commission No. ti 3C> .i (Sea(}_
REVIEWS I' FRONT ZONING SUPERVISOR PLANS VEGETATION SEA'TURTLE MANGROVE
COUNTER REVIEW REVIEW . REVIEW REVIEW REVIEW REVIEW"
DATE i
.RECEIVED
DATE
COMPLETED a
kev.516Y20—__.