HomeMy WebLinkAboutBuilding Permit Application Docu: ign Eriveloge ID.4D'46i880-8DC3-4QA7-8E25»E5s 9676 #Dt
All APPLICABLE INFO MUST,BE COMPLETED F+�R APPLtCATtC�tV TCt$E ACCEPTED
Fate: 3jt3j2021 3
Per
mit Number:_.» � � J
l
RECEIVED'
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MAR
�< L } �y;'cd _ ter' iago r
Permittir.9 D ari m.
S, Wcie
P;ernniri crnt�6euelopmentServices Residential
Build'ir+g and Code ReguiatJ0P,,Dhds ort Commercial
ti7f i C1B�
j300 Viretinic'�venue,fart Pierce FL 34982
{7 2)462-1578
Phone 772 46�1553 FOX,— ?.
L�o
i PIP IC'ATIQI "FOIE.DEMO .1TIO
£��t` +1 'T.L0GA D-M rc�va--:
8637 South US Highway One P Ort t.Lucie,PL " !
34145011912500,6. Lot No.
Property Tax, Crowne Plaza/ Project x Block Nc�• 3
.: Site P}3ra iV�irxae:
Truant pace 8637
Project Name SL
I IL. E.� I .3L..i 11T'TF I' OF L�As°[3
lhterior drys f l removal over the existing slore rout window.an
eR efevated platform and knee Wall.
Patch.dryut [I ar;ti paint areas affected by demolition,
s -
YFlevr l lectricaI Meter �^lA4� Second Electrical Meter=,
Additic rtal tirnrk to be perfarr ed under tisis'perMit-check all that api ly:
mechanical Gas lank Sas Piping _ �Shutters l�Vindowsf Doors _ .Pond
_Electric _Plumbing �Sprinklers Gen erator Rc�o� Pitch
Total SG,i i df Construction:
Sq.Ft, of First Floor: —
frC�St of'Construction 15 714:flt� Lltilltt8 : Set-'+er Septic 8uliding height:
F
t� �.crowne St 1 UCH Associates LP Name.
:rtd1jold F_I<irchman ti
j Name
t 1r tarnan.,�ConstructiOn Ca_
•i bi va one �.compan :,.•�.
Address*
8613 S. tas H g y
State: FL, Address:1241 S E Indian Street suite 108
City; part'St, LUCTe
Zip Code. 34952 Fax: 772-807= l cit:y: Stu rt State;!'L
83-8Q6-8235 2pCtde 34997 fax: 772-283-157tt
Phone
E-read
nehorG�craelr€ecammerciai.eoa Phone t�lu" -7r'2-283 G25€a
Fist an fee ira�Rte.Title-Holder:o next Peke{if different E-Mail ronnie@kirchma.nconstruction.com
E C C048554
State or tourity License
fr€arra the wt uc ran s listed
2aCt0 or
more,a RECORDED Nflticee of Commencerr�
if value of co ent is requ"sred.
!$value of iAVC is7,5t1t#®r:i�i+xre,a RECt7RREd .�Ji#ire of Commencement%s regkslred,
DM-AiSigil Envelope ID-'4D467BBS-8DC34DAt-SE2B,F51E'157651OF
' P I ` ,M E, -- L N5,. FO.. Mr -
MORTGAGE. - x fin[Applicable COMPANY: Xx Not Applicable
t�ESIGNER/MINEER�
Marne. IWat onwi de Life:Insur anei Company
Name:
Address: Andress
C'it .� _ State:__�__ City;City: _Cclia�ratau � ,c� Stafe:
Zip: _ --JPhone_ Zip, Phone:
_ _._ NNot Applicable BONDING ICOIMPANY: _Not Applkable
FEE SIMPLE TITLE',H�€.DEI� �_�
Name:
Name: >
Address. Address — --
City C'sty:
,
Zip; Phone:
Phone: ;
- Zip:_ —._.
t3V1 NER/CONTRACTOR!AFFIDVIT:Application is hereby,Made to obtar rmit try dc�the w rl:and installation as indicated.
tion has commenced prior to the issuance Of o pe
1 certify that no work.or installv rmit.
St.Lucie Count makes no representation that is ranting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Norge Owners Associatsonruevi bylawsour or and covenants rest that n w ich may ape y abitsetch
structure.Please consult with your,Home Owners Association-asrd re your deed for any restrictions whim h a 1 .
In consideration of the granting of this requested,permit,i do hereby agree thatti t+vill,in all respects,perform the work
in�4ccordancekvith tl�e approved plans,the Florida building Codes and St-Lucie(aunty Amendments.
The following building permit applications aree,exempt from undergoing a full cancurrency review*roorn additions,
accessory structures,swimming pools,fences,wails,signs,screen rooms and accessory uses to another non-residential use
paying t
WAI�NtNIa :# OWNER:: Your failureto Record a Notice of Commencer�aerst may result in.paying far
improvements to your property.A Notice of Corrirnencement rr ust-be recorded in the public reco s of St.
Lucre Catr.nty and posted on the jobsite before the first inspection.If you intend to obtain€ina g, consult'th le er or.an attt rn—! before corn encin �vt rlt r rec�rdirt coon ti f Ca ent. —
Signature trf C�vn r�L seer'Coratractds as-Agent for[owner Signature of rrntractor/License Holder
STATE€�F F Co4 STATE OF>;LO I!D ��^
COUNTY OF � r � COUNTY OF �.—_�---
rued and subscribed before n e of Sw rn to lor`aff€rrned)and subscribed before me.of
S�v to(on affirmed) 1 Ph sie,�I Presence or _ Online Ncr4arrzatlon
PhyslcaE Presence ran t7riline No arz�aEiorr,
�0"r by this day o€�_r —�20?0 by
this day of, /� __ ;
�akn,^1 I
Name of person nal�ring state neat.
Name of person making staternenL
°. Personally Known_`� _.t Fi Produced Identification,--,,— Pers"Illy Known--OR Produced Identification
• Type of Identification ype of iden� Ic
Produced
f Produred ,„, -
�
{Signat re of N
f5ignatut eaf Notar r Public-State o€:lorida}
R
EiV S. N I ELS EN
' I o`P `B' Stare of 1or � nary Public
Comrr�ssron ° m. HASH HA(60 Cernrrtisslt�n No ,2 n # GG 207454
ommis�io
61t4kCOo NOTARY PUBLIC-STATE OF COLORADC. " a M Commission Expires
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l MY COFhFAi SION EXPIRES AN 5, t• r ru
REVIEWS , c RVISDR PLANS 1JE
COUNTER REVIEW REVIEVV REVIEW EW REVIEW REVIEW
DATE
RECEIVEE3
VATS d
COMPLETED
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