HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMP ED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: �� U,�LQb
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Building -Permit Application
Planning and Development Service's
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Kenneth and Lynn Brown
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Address: 5261 Tree Top Trail, Ft Pierce;FL 34951
Property Tax 10#: 1407-343-0010-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Brown residence
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new in ground pool
New Electrical Meter Second Electrical Meter
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Additional work,to be performed under this permit—check all that apply:
_Mechanical _Gas Tank Gas Piping Shutters Windows/Doors _Pond
Electric _ Plumbing W Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: . Sq. Ft. of First.Floor:
Cost of-Construction: $ 200.00 Utilities: —Sewer _Septic Building Height:
-
Name Kenneth &Lynn Brown Name: Warren Sigman
Address: 5261 Tree Top Trail Company: Florida Lifestyle Pools
City: Ft Pierce State:_L Address: 1469 Sw Balmoral Terr
Zip Code: 34951 i' Fax: City: Stuart State:FI
Phone No. 646-217-8727 Zip Code: 34997 Fax:
E-Mail: Phone No 772-237-7665
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
tf 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:D94CIB68-2687-4A1D-9C07-C7AC820835E
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'DESIGNER/ENGINEER:. _Not Applicable i MORTGAGE COMPANY: _Not Applicable
Name:MARKHAM SERVICES INC p572.6. Name:
Address:'BroNE J`NstN BEACr BLVD. Address:
i City: .ENSENBEACH State:F- City: State:
Zip: °sr Phone Zip: Phone;
FEE SIMPLE TITLE HOLDER_: Not Applicable BONDING COMPANY: Not Applicable
Name: 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:ssuance of a permit.
St.Lucie County makes ro 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 RecoPd 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 inspect' If you intend to obtain financing,consult
with lender or an attorney before commencingwork or rec I our Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signa e cif Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF &VqP--I'SIV COUNTY OF {bA2T�IlI
4 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 VA Ong e." 2021 by this_day of 202D by
! Name of person making statlament., Name of person making s
/tatement.
Personally Known OR Produced Identification ✓ i Personally Known ✓ OR Produced Identification_
Type of Identification Type of identification
Produced L Produced
Nerry A. Sisson Kerry.A. Sisson
(Signatur lsignatwm 1111.2LI:
Notary Pubic Stets lFlo ida Notary Public Ste l
Commissi ) Sisson ea} i Comm io o on
L My Commission GG 960211 My Commission GG 9W211
* or
REVIE OR PLAN OVE
COUNTER REVIEW REVIEW REVIEW i REVIEW REVIEW REVIEW
DATE -
RECEIVED —--
DATE
COMPLETED _ -
eV. J20