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HomeMy WebLinkAboutBuilding Permit Application I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ' �' Permit Number: uo RECEIVED O p Building Permit Application MAY 12 2021 Planning and Development Services P:armitti,)g Department Building and Code Regulation Division Commercial Residential 5X Lucie Count;! 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: Window & Door Installation PROPOSED IMPROVEMENT LOCATION: Address: 12065 Riverbend Drive Port St. Lucie, FL 34984 Property Tax ID#: 4422-502-0011-000-9 Lot No. 7 Site Plan Name: Bay St Lucie Lot 7 (MAP 44/22N) Block No. Project Name: Hamill DETAILED DESCRIPTIOWOF WORK: l f1Ska ll C)e-w ek wt bdcxx,S C,nA Cke'n -S New Electrical Meter Second Electrical Meter [CONSTRLICTI'6'N'INIFORMATION: 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:$ )LI, o1©•C)o Utilities: _Sewer _Septic Building Height: IF OW'N ER/LESSEE: CONTRACTOR. Name Gifford Hamill Name: Douglas Sammons Address: 12065 Riverbend Drive Company: Hall-Sammons Inc. City: Port St. Lucie State:_ Address: 1101 NE Martin Avenue Zip Code: 34984 Fax: City: Jensen Beach State:FL Phone No. 603-661-5433 Zip Code: 34957 Fax: E-Mail: giffh@aol.com Phone No 786-337-5107 Fill in fee simple Title Holder on next page(if different E-Mail lisa.halisammonsinc@gmail.com from the Owner listed above) State or County License CRC1326546 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. Ik ���k�,.u�'w�".%' 7"�f` DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: —Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: 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 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 re i our Notice of Commencement. Signature ontractor as AgAnt for Owner Signat ctor icense Holder STATE OF FLORIDA STATE OF FLORIna COUNTY OF SY Lt.tN COUNTY OF S �Sworn o(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of ysical Presence or' Online Notarization Presence or Online Notarization this�3_ldday of r ,2020 by this day of 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification 4CLn(, Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced FL,1,C_ (Signature No Pu ic-Sttaatte ff FF rida ) (S' re of N a 'P lic-State o 0 ti e':. JMjRQGAAgA e c G. ;_, n, SAVITRI GARCIA _ ^•'• Notary Public-State of Florida �s Notary Public-State��ffg a Commission { `= ion#GG 95is"al) Commission No _ • tssion k GG 4��3 °Ff`' My Comm.Expires Apr 1,2024 ""'••••••"'° My Comm.Expires Apr 1,2024 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE —F COMPLETED Rev. S 20