HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/23/2021
Permit Number:
�7 M
P it @ W Q D 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: Construct New Residential Residence
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #:
Site
Plan Name:
Project Name:
8032 S Ocean DrivePort Saint LucieFL 34984
3527-501-0020-000-1 Lot No. 19
DIAMOND SANDS PLAT NO. 2 Block No.
D
IAMOND SANDS PLAT NO 2
DETAILED DESCRIPTION OF WORK:
Construct New Single Family Residence
New Electrical Meter Second Electrical
N
CONSTRUCTION INFORMATIO:
Addit'onal work to be performed under this/ppermit— checlt all that apply:
Mechanical _Gas Tank ^/Gas Piping _Shutters Windows/Doors _Pond
_Electric ,Plumbing JSprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Thomas E Williams and Karyn Williams Name: Stephen D. Temmel
Address: 330 SE Fascino Circle Company: Oakmont Custom Homes, LLC
City: Port Saint Lucie, FL State: Address: 735 S Colorado Ave., Suite 109
Zip Code: 34984 Fax: City: Stuart State: FL
Phone No. 703-408�2277/561-400-8530 Zip Code: 34994 Fax:
E-Mall: tewilliams52@yahoo.comlkaryn.williamsl9@yahoo.com Phone No 772-210-5438
Fill in fee simple Title Holder on next page ( if different E-Mail ARHOMESPERMITTING@gmail.com
from the Owner listed above) State or County License CGC1506509
If value
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
Designer/Architect/Engineer: ❑ Not Applicable
Mortgage Company: 0 Not Applicable
Name
Name
Mailing Address
Mailing Address
city State
City State
Zip Phone
Zip Phone
Fee Simple Title Holder's Name: ❑ Not Applicable
Banding Company: ❑ Not Applicable
Name
Name
Mailing Address
Mailing Address
city State
city State
Zip Phone
Zip Phone
Notice to Owner: There are some properties that may
have deed restrictions recorded upon them, These
restrictions may limit or prohibit the work applied
for in your building permit. It may be to your
advantage to check and see if your property is encumbered by any restrictions.
Owner/Contractor Affidavit: Application is hereby made to obtain a permit to do the work and installations as
indicated. I certify that no work or installation has commenced prior to the issuance of a perznit.
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 Code 7tb Edition (2020) and Martin County
Amendments. Plan revisions on all structures exempted by code from architect/engineer design may be done by
permit holder,
Warning to Owner: Your failure to record a Notice of
Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement
must be recorded and posted on the job site before
the first inspection, If you intend to obtain financing,
consult with your leader or an attorney before
commencing work or recording your Notice of Commencement,
I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
Signature of Owner/Agent/Lessee
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE Or, FLORIDA
COUNTY OF MARTIN
COUNTY OF MARTIN
Tile fore ping mstr ent was acknowledged before me
Phis day of 2091 by
The foregoing msnv at was aclnowled ed before me
this_ day - Be;(' 20,� by
gg@ ,
of
r� ,
(N re of Person Acknowledging)
(Name of arson Acknowledging)
(Si aatme of Notary ublic Stale ofFtorida) 6'(SigtYanneofNotary
Pout ic— State of Florida)
(Print) Type, or Stamp of Notary Public)
(Print, Type, or Stamp Name of Notary Public)
,Coo'mmissionedName
Personally Known
cololarmdsamned
h% ORProduced Identification_
Personally Known OR Produced Identification
Type of Identification Produced
Type of Identification Produced
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ADA Accessibility Disclosure Statement -This document may be repr494
oduced upon request in 2rivat rnli1 AQfOR NOi21jz
by contacting the County ADA Coordinator (772) 320-3131, the County Administration Office (772) 288-5400,
Florida Relay 711, or by completing our accessibility feedback form at www.martin.Il.us/accessibility-feedback.
Rev.01-21