HomeMy WebLinkAboutKidwell Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 5C1 -at
Permit Number:
9)'110 Lucm
4440L')ftt'� �,a...0 Building Permit Application
Planning and Development Services /
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 5'909 \t\jin�e4 J20e►1 L'y'►,hs1 ei'ec( FL- 47j
Property Tax ID #: j3� � - �« - L 11 1 V Vl , 9 Lot No.q
Site Plan Name:
Block No. _ V)
Project Name: 37arnf.S;�, �l
DETAILED DESCRIPTION OF WORK:
l f ' 1' ' 1 . 0.11M ii t ► ' 1 i II
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
— Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 1 i g05
Cost of Construction: $ 5,9a(o ,
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
_ Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ZC{M6 4;6wef I
Name: Robert Noeker
Address:_5(j+� W�nle�Garrlen �are�_
City: )ar-�- ?;e3ce- State: FLL.
Zip Code: 3 LI 9 5 1 Fax:
Phone No. -11c�- 50 - OSq/
Company: Service Star Air Conditioning and Heating
Address:18735 E. Colonial Drive Suite 100
City: Orlando State: FL
Zip Code: 32820 Fax: 407-568-2766
Phone No772-770-3733
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail info@servicestarcoolingandheating.com
State or County LicenseCAC055550
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: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:_
Address:
City:
Zip:
I T.TiTO
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:!
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
kArith hmnrlpr nr an attnrnav hefnre commencine work or recordine vour Notice of Commencement.
Signature of Owner/ Lesse Contractor Agent for Owner
Signature of Contract License Holder ,
STATE OF
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FLORIDA
COUNTY OF1r(k
COUNTY
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
✓
Sworn to (or affirmed) and subscribed before me of
Notarization
Physical Presence or Online Notarization
✓P slcal Presence or Online
this � ay of 202't by
this day of Y1�1G(►T�, 2024 by
ohea I �W
��d l aLy-
Name of person making statement.
Name of person making statement.
'/ OR Produced Identification
Personally Known V OR Produced Identification
Personally Known
Type of Identification
Type of Identification
Prodliced
Pro ced
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ignature of Notary Pu lic State of Florida)
ignature of Notary Public- t e of Flor'd
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Commissio OiraYAo`'.. AMANDALITTLE(Seal)
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AMANDA LITTLE
Commissl n' vcuel ,=5tateofFI r�&e
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Notary Public State of Florida
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Commission GG 915595
Commission a GG 915595
1UPERVISOR
':9>°F: X Tres Jan 19, 2D24
REVIEWS ::
Bonded through
National Notary Ass
Bonded throug
PLANS
National Notary ssn.
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20