HomeMy WebLinkAboutBldg Permit Application - KleinAll APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -3 �0 21 Permit Number:
O
Building pp Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential XXX
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Addition to existing 2 story residence
PROPOSED IMPROVEMENT LOCATION:
Address: 12772 NW Mariner Court, Palm City, FL 34990
Property Tax ID #: 4425-603-0010-000-1 Lot No.
Site Plan Name: Klein Block No.
Project Name: Klein Additioin
DETAILED DESCRIPTION OF WORK:
Add Staircase, Elevator, 2nd Floor Sitting Room, and Master Bathroom Remodel
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
X Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond
X Electric X Plumbing _ Sprinklers _ Generator ' Roof Pitch
Total Sq. Ft of Construction: 544 Sq. Ft. of First Floor:
Cost of Construction: $ 275,000.00 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Susan Klein
Name: Jeffery A Bowers
Address: 17 Black Birch Lane
Company: Masterpiece Builders
City: Concord, MA State: _
Address: 410 Colorado Avenue
Zip Code: 01742 Fax:
City: Stuart State: FL
Phone No. 772.777.4099
Zip Code: 34994 Fax: 772.283.2770
E-Mail: srowlandk@aol.com
Phone No 772.283.2096
Fill in fee simple Title Holder on next page ( if different
E-Mail jbowers@masterpiecebuilders.com
from the Owner listed above)
State or County License CGC 048543
If
value of construction is 7snn nr mnrn n arrnunrn ni-+c, s r
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: x Not Applicable
Name: MA. Corson
Name:
Address: 412 Colorado Avenue
Address:
City: Stuart State: FL
City: State:
Zip: 34994 Phone 772.223.8227
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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 recordin our Notice of Commencement.
SignA AfO "ner�/LeLssee/Contractor as Agent for Owner
Signaj�of Con ac or/License Holder
STATE OF FLORIDA
STATE 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
xx Physical Presence or Online Notarization
this 3rd day of February 2020 by
this 3rd day of February 2020 by
Jeffery A Bowers / Contractor as Agent for Owner
Jeffery A Bowers / Contractor/License Holder
Name of person making statement.
Name of person making statement.
Personally Known xx
sonally Known xx
Type of Identification :'Y'
Produced ;,,: MY COMMISSION#GG3677
T e of Identification ��" CYNTET�UNI_G
P: EXPIRES: September 23, 202
P duced ? OMMIG7784
`m�
ThNN Public UndelWri
otary
EXPIRES: , 2023Bonded
rs 1 :,:.Bonded
TluuNetwdters
(Ignature of No ry Public State of Florida )
(Signature of Notary Pu ic- State of Florida)
Commission No. GG367784 (Seal)
Commission No. GG367784 (Seal)
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