HomeMy WebLinkAboutDeegan-Permit Application.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/11/2021 Permit Number:
`T, LLLLL
' Building Permit Application
Planning and Development Services
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:Alliance Group
PROPOSED IMPROVEMENT LOCATION:
Address: 969 Nettles Boulevard Jensen Beach, FL 34957
Property Tax ID #: 4502-501-1156-000-6
Site Plan Name:
Project Name: Thomas Deegan
DETAILED DESCRIPTION OF WORK:
Lot No._
Block No.
Remove existing roof covering, renail deck, install self -adhered underlayment and 040 aluminum 1" standing seam
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
Total Sq. Ft of Construction: 1,598
Cost of Construction: $ 15,527.00
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof 4
Pond
Pitch
Utilities: —Sewer _Septic Building Height: 12�
OWNER/LESSEE:
CONTRACTOR:
Name Thomas Deegan
Name: Danielle Ryckman
Address: 969 Nettles Boulevard
Company: Alliance Group
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No.772-240-8134
Address: 615 NE Enterprise Drive
City: Port Saint Lucie State: FL
Zip Code: 34986 Fax:
Phone No 772-492-8006
E-Mail:.frontdesk@alliancegrouplic.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail adamleeryckman@gmail.com
State or County License CCC 1330918
if value of construction is 25W 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 TITLEHOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: I Name:
Address:
City: City
Zip: Phone: Zip:
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 attornev before commencine work or recordinia vour Notice of Commencement.
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Signaturel of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SsmLLuae
COUNTY OF sa,�I LWe
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this >> day of May 2020 by
this i? day of May 2020 by
Danielle Rycknian
Danielle Ryc rnan
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produce
(Si ature of Notary Public- State of Florida)
(gnature of Notary Public- State of'lo�A.ai�
r
Ryan R. Sable
?
Commission No. Notary Folail t)
Commission No. Notary
State of Florida
State of Florida
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Expires4/
2025
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Rev. 5/b/20