HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: February 23, 2021 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: Deck Addition
PROPOSED IMPROVEMENT LOCATION:
Address: 12351 S. INDIAN RIVER DRIVE, JENSEN BEACH, FL, 34957
Property Tax ID #: 4504-603-0013-000-4
Site Plan Name: EDICK DECK ADDITION
Project Name: EDICK DECK ADDITION
I DETAILED DESCRIPTION OF WORK:
DECK ADDITION -Pre~u('"e.-\rea+-e.d I.OOOd 2 7 ' X l~'
New Electrical Meter ____Second Electrical Meter______
' ~ CONSTRUCTION INFORMATION:
Additional work to be performed under this permit check all that apply:
_Mechanical Gas Tank Shutters _ Windows/Doors
Lot No. 3._--
Block No. --
Pond
Electric _ Plumbing
_Gas Piping
_ Sprinklers Generator Roof ____ Pitch
Total Sq. Ft of Construction: . Sq. Ft. of First Floor: __________
Cost of Construction: $ 'lY) Cf\ 2,00 Utilities: Sewer _ Septic Building Height: ____
OWNER/LESSEE: CONTRACTOR:
Name MICHAEL G. & DEBRA L. EDICK Name:MACK MATOS
Address: 17517 PRINCESS ANNE DRIVE Company: MEL-RY CONSTRUCTION, INC.
City: OLNEY, MD State: -Address: 10967 S. OCEAN DRIVE
Zip Code: 20832 Fax: City: JENSEN BEACH State:~
Phone No. Zip Code: 34957 Fax: 772-229-9440
E-Mail: Phone No 772-229-9440
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County license GCG059412
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: _x_ Not Applicable MORTGAGE COMPANY: _x_ Not Applicable
Name: Name:
Address: Address:
City: State: -City: State:
Zip: Phone 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 th is requested permit, I do hereby agree that I will, in all respects, perform the work
i n accordance with the approved plans, the Florida Build i ng 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 attorne before commencin work or recordin our Notice of Commencement .
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA -a. luci
COUNTY OF ....;1, " e
1.l0 to (or affirmed) and subscribed before me of
Physical presr~ce or Online Notarization
his l day of JVlt1.t'CYL .202t by
AAaa Ma:t02
NamJOf person maki ng statement.
Personally Known A--OR Produced Identification __
Type of Identification
Produce '1'_ _____--,~---
I "";S,v;;'',;:'' KATHLEEN GANNONI ..,Os" ... . ' ':'.;••
Commission No. __~f ~:'-i'__~\:j MY Cq~~~ION #GG 914400
,.~. .'!; EXPIRES: January 18, 2024
·<f.~·f:!~?~'" Bonded ThN Nolaty Public Unde1writara
STATE OF FLORIDA I , .... _."
COUNTY OF ~.~e.-
S~~to (or affirmed) and subscribed before me of
A.~hysical pre~Online Notarization
this l day of . ,202t by
AkKMLt1Ir?
Name of person making statement.
Personally Known X
Type of Identificat ion
OR Produced Identification ___
Produced+-_____-,....,-___
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR PLANS VEGETATION SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
REVIEW REVIEW REVIEW