HomeMy WebLinkAboutBuilding permit app, pg 2SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: �5 /kuc ` t ocA7—
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City: t S 5t (,- State: PY
Zip:! 7`f Phone E7— F7_,Fyoo C�rj-1Q
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: 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, 1 do her by agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codesland 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 �ooms 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
withknder or an attooey before commencing work or rec)Wding your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner I Sig ature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
V Physical Presence
Sworn to (or affirmed) and subscribed before me of
or Online Notarization
this _14P day of 204 by
iy` Physical PresepAe or Online Notarization
I this _La day of 4-Ifl `fN 1 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced-� ����1 y ( j�{G1�
Prod uced-JO )1_kr5ST74I W L y cj
(Signature of Notary Public- Itat offiiib�da) CASSANDRA M VOLAG
(Si nature of Notary Public- Aate
+ r,'; Notary Public - State of Florida
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CASSANDRA M VOLAG
Commission No. Z321
I Commission n GG 9232
Comm. Expires Oct 16,
.'a N ry Public -State of Fi
mission No. GZ321ea9
(�� ommissio., GG 9232
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danced through National Notary
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REVIEWS FRONT
ZONING SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
MICHELLE R. MILLER, CLERK OF THE CIRC IT COURT - SAINT LUCIE COUNTY
FILE # 4842424 OR BOOK 4584 PAGE 23 9, Recorded 04/05/2021 03:51:03 PM
Permit No. roperty Tax IDNo. 4422-810-0006-000-7
State of Florida, County of St. Lucie
The Undersigned hereby gives notice that improvement %vill be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is I rovided in this Notice of Commencement.
Legal Description of property and address if available 512 NJW Winter Creek Road- Harbour Ridge Plat 20 Lot C
General description of improvements Kitchen Remodel
OwnerAessee Paul Harper
Address 1053 Brackening Road Unit 7 - Port Carling, ON DO 1 JO Canada
Interest in property: Owner
Fee Simple Title holder (if other than owner)
Address
Contractor RA Construction Corp of the Treasure Coast; phone # 772-260-8419
Address 850 NW Federal Hwy#226 Stuart, FI 34994 Fax #
Surety Phone #
Address Fax #
Amount of Bond
Lender Phone#
Address Fax #
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13 (a) 7., Florida Statues:
Name
Phone #
Address Fax #
In addition to himself, owner designates of
Phone # Fax #
to receive a copy of the Lienor's Notice as provided in Sectionl713.13 (1) (b), Florida Statutes. (Expiration date of notice of
commencement is one year from the date of recording unless is 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 CH.713.13, F.S., AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB ITE 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
COMMENCMENT.
�OywJnye/Le or O, Ner's or Le ee's Authorized Ofticer/Director/Partner/Manager/ Signature
! / SIg.btO Ftle/0
State of Florida, County of
acknowledged before me this S•+-N . day of 20 ZZ4 . by�Q_,tt✓�
tivti ' ersonall known to Ins who has produced as identification.
'-1-n - cane �J.
Signature of Notary Type or Print Name of Notary (Seal)
Title: Notary Public Commission Number
CAROL N. ADAMS
_ ,$ �,Jq17•7,,jj � M( COMMISSION #= 223226
EXPIRES: July 16, 2022
.�.f,�.. ;q°'�' Bonded Ilya Notary Public UMelwRers
I IIEREBYCERTIFYTHATTH IS DOCUMENT IS A TRUE ANDCORRECTCOPl OFANOFFICIAL RECORD OR Ngltally Signed by The Honorable Michelle R. Miller
DOCUM ENT AUTHORIZED BY LA\V TO BE RECORDED OR FILEDANDACTUAL11 RECORDED OR FILED IN Lat2: 2021.04,OS 1S: S2:Z1 -04:00
THE OFFICE UFTHE ST.LUCIECUUNr'YC'I STHE, CIRCUFFCUDRT Reason: Electronically Certified Copy
THIS DOCUMENT MAY HAVE REDACTION'S AS REQURK IRED
AN' BY L,
VISIT H,-rPSIrsTLDCIECLeaR.coMrseRvlasre.ceanFr-oFFIc1:,L.RecoRDS To \:,ueArE THIS DOCDMe r. Location: 201 South Indian River Dr, Fort Pierce, FL 34950