HomeMy WebLinkAbout1. Permit AppDocuSign Envelope ID: CE8A3C40-lAA2-0866-85A6-06715910741F
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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L- Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential YES
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: LORD BLAZER
1
PROPOSED IMPROVEMENT LOCATION:
Address: 1200 PARKLAND BLVD
Property Tax ID tt: 3409-703-0038-000-7 Lot No.18/19
Site Plan Name: RIVERDALE YACHT CLUB ESTATES Block No. 4
Project Name: LORI BLAZER
DETAILED DESCRIPTION OF WORK:
NEW IN GROUND POOL
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 _ Windows/Doors _ Pond
'-"Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 35200.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameLORI BLAZER IName: WARREN SIGMAN
Address: 1200 PARKLAND BLVD FLORIDA LIFESTYLES POOL
-- Company:
City: FT PIERCE State: _ Address:1469 SW BALMORAL TERR
Zip Code:34949 Fax: City: STUART State:FL
Phone No.772-359-9291 Zip Code: 34997 Fax:
E-Mail: GJ Phone N0772-237-7665
Fill in fee simple Title Hold r on next page ( if different E-Mail OFFICE@PROPPOLBUILDERS.NET
from the Owner listed above) State or County License CPC1457647
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.
DocuSign Envelope ID: CE8A3C40-1AA24B66-85A6-06715910741F
DESIGNER/ENGINEER: _ Not Applicable
Name: MARMAM SERVICES MC (57216)
-Mau: kii
MORTGAGE COMPANY: x_ Not Applicable
Name:
Add re SS: r 82D NE JENSEN BEACH BLVD N685
City: JENSEN BEACH ,State: FL
Zip: U957 Phone 954�i-112J
Address:
City: State: _
Zip: Phone:
FEE SIMPLE TITLE HOLDER: L Not Applicable
Name:
BONDING COMPANY: x Not Applicable
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 recording our Notice of Commencement
o«uSxjnedNbl by:
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3 Wbwner/ Lessee/Contractor as Agent for Owner
Sig ure ntra License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF C I 111 C IP
COUNTY OF S4- L 1 c tip
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Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
_ Physical Presence or Online Notarization
Physical Presence or Online Notarization
this -day of-naireG� 202b by
_ _
this -day of M(Arg-le1 2020 by
Kerry A._ Sisson
Kerry A. Sisson.
Name of person making statebrent.
I Name of person making staMnent.
Personally Known OR Produced Identification _)C
Personally Known � OR Produced Identification
Type of Identification
Type of Identification
Produced i� L.
Produced
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(Signature of Notary Pub -
(Signature of Nota y P
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