HomeMy WebLinkAboutBashant ApplicationsAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
1 LLLLL
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: I U'(\ (Rn e slr"V' Cs
PROPOSED IMPROVEMENT LOCATION:
Address: M NeTVLFS
Property Tax ID #: `} 5DZ - 5b 1 - b 3`i 1 OQ O - Lot No.
Site Plan Name: kCTI t,C=; 1SLMc _K) 11)C- , ICI\00 Block No.
Project Name: bt'Y-Ocl ' Shan
DETAILED DESCRIPTION OF WORK:
Zyistal fa.),),' C( hu.(ncaoc o(vu+cct -v) Auc-�s U� r) er,)% L
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all th t apply:
_Mechanical _ Gas Tank _ Gas Piping all
v Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 161 . C)C , 00
_ Generator
Sq. Ft. of First Floor:
Windows/Doors — Pond
_ Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name C1E?wd
Name: I\Av-ar) '
/�1t✓�
Address: Ito tii klCS \yL�
Company: a rm
SMa('�
City: State: Ft-
Zip Code: Fax:
Phone No. �,12J tz tO -g9c)s
Address: 9641 6Q Sti+e 104
City: \Nesfi ?0,1,'Y)
Zip Code: =iD�
Phone No (Sul)
y6cr", A Stater
Fax:
E-mail:�c 35 ����\ ( ayr .a,k\ . Cl.y'Y1
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailer(rY\, •twic\ r�srn�<kse • cc�r�'�
State or County License
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.
Ak
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: K Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
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
impro ements 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
wit lender or an attorney before -commencing work or recording your Notice of Commencement.
ign ture of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contral:,tor/Licenle
Holder
STATE OF FLORIDA ,
P'C'
STATE OF FLORIDA
COUNTY OF
COUNTY OF P6c
Sworn to (or affirmed) and subscribed before me of
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Swgrn to (or affirmed) and subscribed
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before me of
Physical Presence or Online Notarization
Physical Presence or
Online Notarization
this J� day of Fc V�) 2026 by
this 'Z-4 day of
202$ by
C�Umi (do4ar
Name of person making statement.
Name of person making st1itement.
Personally Known OR Produced Identification t//
Personally Known OR Produced Identification
Typ f Identification ���
Ty ntification
Pr duce �-- :' � � h� �
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REVIEWS
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SUPERVISOR
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VEGETATION
SEA TURTLE/
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
COUNTY
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PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Poa�Ws Elea
(Company Name/Individual ame)
the t C �Yl CCt,, Sub -contractor for
(Type of Trade)
For the project located at
have agreed to be
We.P,n &4w 1 Sim SntaA
(Primary Contractor) I SUJkA (CS4 e(,
(Project Street Address or Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
�4
CONTRACTOR NATUR Qualifier)
Weal R �r
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of l—
The foregoing instrument was signed before me this zq day of
IMIrct 20 ZI , b% -Noaw e t nyel
`i
who is personally known _ has produced a
AS
51:AMP
Sig tture of \ ablic
' /�. '� \\\1�\1111III#/////�
Print Name of Notary Public \`FCK. /1//z
NOTARY 9N:
PUBLIC
C*$C~ Revised 11/16/2016 % O tb'
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OF/o/11111iF� OP\O`�.
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SUB -CONTRACTOR SIGNATURE (Quslider)
PRINT NA ME
Sagy0
COUNTY CERTIFICATION NUMBER
State of Florida, County of l0L
The foregoing instrument was signed before we this day of
ch zo2A,by�nc�
who is ersonally known or haswproduced a
STAMP
Lure o f Notary Public
ro 1I — t I ra \- 111111111//
Print Name of Notary Public \ \tAA K.
P ........ , /Y
`� 5 .�t,A1551pN •.• � ��i
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NOTARY 9N::
PUBLIC i
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FILE # 4834865 OR BOOK 4575 PAGE 744, Recorded 03/19/2021 11:29:35 AM
PERMIT #
TAX FOLIO NUMBER a j4`) -000-5
NOTICE OF COMMENCEMENT
STATE OF FL
COUNTY OF -'A, (UC,e
THE UNDERSIGNED HEREBY GIVES NOTICE THAT IMPROVEMENT WILL BE MADE TO CERTAIN REAL PROPERTY, AND IN
ACCORDANCE WITH CHAPTER 713, FLORIDA STATUES, THE FOLLOWING INFORMATION IS PROVIDED IN THIS NOTICE OF
COMMENCEMENT.
1. DESCRIPTION OF PROPERTY: (LEGAL DESCRIPTION OF THE PROPERTY AND STREET ADDRESS IF AVAILABLE)
4�TLi ES ISL,AN1b INC A C,oNno-TAq-(EC 1tv"L AM S+\ ►�i to
2. GENERAL DESCRIPTION OF IMPROVEMENT: f:LE��NiII S) ICI (\1Z11��'S P�'wd JensZn f�each,{L �y��
Installation of Hurricane Protection
3.
UVVNtK INt-UFIMA I IUN: A. NAME: GERALD BASHANT
B. ADDRESS: 161 NETTLES ISLAND DRIVE JENSEN BEACH FL 34957
D. NAME AND ADDRESS OF FEE SIMPLE TITLE HOLDER (IF OTHER THAN OWNER):
C. INTEREST IN PROPERTY: Oyo ne r
4. CONTRACTOR INFORMATION. (NAME, ADDRESS & PHONE NO)
Storm Smart Building Systems 6182 Idlewild St. Fort Myers FL 33966 (877) 212-5453
5. SURETY. (NAME, ADDRESS, PHONE NO & BOND AMOUNT)
LtNULK INF-UHMATION: (NAME, ADDRESS & PHONE NO)
7. PERSONS WITHIN THE STATE OF FLORIDA DESIGNATED BY OWNER UPON WHOM NOTICES OR OTHER DOCUMENTS
MAY BE SERVED AS PROVIDED BY SECTION 713.13 (1)(A) 7., FLORIDA STATUTES:
A. NAME, ADDRESS & PHONE NO:
8. IN ADDITION TO HIMSELF/HERSELF, OWNER DESIGNATES THE FOLLOWING TO REVEIVE A COPY OF THE LIENORS
NOTICE AS PROVIDED IN SECTION 713.13 (1)(B), FLORIDA STATUES: (NAME, ADDRESS & PHONE NO)
9. EXPIRATION DATE OF NOTICE OF COMMENCEMENT (THE EXPIRATION DATE IS ONE YEAR FROM THE DATE OF
RECORDING UNLESS A DIFFERENT DATE IS SPECIFIED)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713 PART I SECTIONS 713.12 FLORIDA
STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU
INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING AND THAT THE FACTS IN IT ARE TRUE
TO T E BEST OF MY )KNOWLEDGE AND BELEIF (SECTION 92.525, FLORIZPR
ATUTES).
L`
SIGNATURE OF OWNER OR LESSEE; OR, INT NAME
OWNER'S OR LESSEE'S AUTHORIZED AGENT
6 wtiF- �-
(:(')MPANV NIAKAF ANIr) TIT] C
STATE OF: F L
COUNTY OF: j
SWORN TO Aft B'CRIBED BEFORE ME THIS DAY OF M C-u-(,h 20Y— 1, BY t
WHO IS PER NAL Y KNOWN TO ME OR HAS PRODUCED nit AS IDENTIFICATION
Yesenia Sarzuela
(SIGNATURE O RY PUBLIC) NOTARY PUBLIC
STATE OF FLORIDA
? Comm# GG317472
(PRINT OR STAMP COMMISSIONED NAME OF NOTARY PUBLIC) cE 9� Expires 3/28/2023
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