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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 05/14/2021 Permit Number: S44 lr.L url(= FRVED } o� 4 - ` � Building Permit Application7 2021Planning and Development ServicesBuilding and Code Regulation Division Commercial Residey, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 1 Phone:(772)462-1553 Fax:(772)462-1578 PERMIT APPLICATION FOR: NATIVE TIKI/CHICKEE HUT NEW BUILD Address: 602 E Midway Rd, Fort Pierce, FL 34982, USA Property Tax ID q: 3402-605-0094-000-5 Lot No.4 AND 5 Site Plan Name: INDIAN RIVER ESTATES Black No. 37 Project Name: Backyard Tiki/Chickee Hut IN 0"Lsllallm SEMMOtE 1iK1 HLrr is tiy.Oding a'rw i Chrtea HUS(07 ow Noma S'2nre,No Cement on MumrM,Na Erea t y a 7 be ran.and NC aurnWV n G9 W InslaCed 1 Registered with the Florida Seminole Indian Tribe-Tribe/Registration Number#M0692 i Drawing of Tlki Hut build, as well as a Survey desmostrating property setbacks and Location of Build New Electrical Meter Second Electrical Meter - s 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 6/12 Pitch Total Sq. Ft of Construction: 375 Sq.Ft. of First Floor: 375 Cost of Construction:$ 2400 Utilities —Sewer _Septic Building Height: 14ft �F r>. j Nameosman G Pineda and Gleisi M Salazar Name:Gabriel Antunez Address:602 E Midway RD Company:Seminole Tiki Huts City: Fort Pierce State: Address:9830 NW 45TH ST Zip Code: 34982 Fax: City: Coral Springs FL Phone No.772-940-4043 gotta• 33065 Fax: E-Mail:osmanpineda3l@gniaii.com Phone No786-412-7060 Fill in fee simple Title Holder on next page(if different E-lyailinfo@seminole-tikihuts.com 1 from the Owner listed above) State or County License Florida If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. If value of HAVCIs$7,500 or more,a RECORDED Notice of Commencement is required. 5_,, 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 fender or an attorney before come or recording our Notice of Commencement. rz���.c4ru`uuu,� C�C�a, ,cQt,►:�i�t,�� Signa re of Owner/Lessee/CoraActor as Agent for Owner Si iature of Contractor/Licebte Holder STATE OF FLORIDA STATE OF FLORIDA BROWARD COUNTY OF BROWARD COUNTY OF 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 14 day of MAY 2-82a by this 14 day of MAY 2OW by 2021 2021 Gabriel Antunez Gabriel Antunez Name of person making statement. Name of person making statement. Personally Known OR Produced Identification X Personally Known OR Produced Identification X Type of lde `fic `on Type of Ide `€ atio Produce F D Produce L i (Signatur of IV© P bI' (Signature Notary Pub c- ,,f� ,( LEXY DE LA C w,,•y'1c4�'1��.,� J(� E UE LA CRUZ '» Ptrbllc-State of F o a C mmissl No; { \ - Cammissi n No. f �. *Noti �ta-state of Florl a c- rt'�mission#HGH 11 Commission#HH 1 183 My Commission Expi e My commission or'f �t. 16,2024 REVIEWS FRONT LANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED { Rev.