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HomeMy WebLinkAboutBuilding Permit i All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: P �`C. �'GI1L� 0 Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: 3HS SC_ A%zo50 �,-N Property Tax ID#: `A - 5'( - O(&-A - O o© - Z Lot No. 5 Site Plan Name: Block No. S g Project Name: S,Jj DETAILED DESCRIPTION OF WORK: // J MOVE u Si I�)(� /`ObT NSPt�Ll� Pnr Q ICL"1"11C -GC !A+S`kt.� New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: 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: Z?_00 Sq. Ft.of First Floor: Cost of Construction: $ �_ ,ZS Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Mi."SSA Name: Address:]`iS S A�2oSo t���� Company: ocNA.���1 c�orr.ivl� C City: +-� Sc .��-�( a State:�1 Address: MS SC Lt S-v U,,,c &^'322 Zip Code: S_Vt 0 ) Fax: City: Pdec_ SV_ L.,� .E State: 'FL- Phone No. 7%y - S- 1Z- fo 34 S Zip Code: 2011 S2 Fax: E-Mail: "aL'A-­aSQ (\o--• C.A.-, Phone No '11Z- Z41 .'41 S`/ Fill in fee simple Title Holder on next page( if different E-Mail A cco�n+r•n�y ��w tfq.+r���F' �+� from the Owner listed above) State or County License CCU 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/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 recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF . L.` Z Sworn to(or affirme )and subscribed before me of ✓ Physical Presence or Online Notarization this Qfh day of 20Q] by Name of person making statement. Personally Known OR Produced Identification Type of Identifica ' Produced FL D' I,I'N ID (Signature of Notary Public-State of Florida ) JOSEPH 8 RIVERA Commission No.I lQJ (Seal) ?P; Notary Public-State of Florida ®` Commission#HH 146015 or M1 My Comm.Expires Jun 27,2025 Bonded through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev NOTICE OF COMMENCEMENT �, 3 mOOF0 O0°u1= Permit No. Tax Folio No. 3419-545-0043-000-2 0 0°A r zArn m 0, State of Florida County of St.Lucie w QQ An 3 oZr The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Flc oD O r7 m -a the following information is provided in this Notice of Commencement. w o-< a� r m Legal Description of Property:(and street address if available): a A X RIVER PARK-UNIT 6- BLK 58 LOT 5 AND 745 SE AIROSO BLVD a r 0 � General description of improvement: ROOF Replacement � m P % c Owner information or Lessee information if the Lessee contracted for the improvement: Name Melissa Ann Cbodubski o Address 745 SE Airoso BLVD Port Saint Lucie, FL 34983 C Interest in property: OWNER Name and address of fee simple titleholder(if different from Owner listed above): Contractors Name: FOxHaven Roofing Group Contractor Address:1193 SE Port St Lucie Blvd #322 Phone Number: 772.249.4954 Surety(if applicable,a copy of the payment bond is attached):Amount of bond:$ Name and address: Phone number: Lender Name: Phone Number: Lender's address: Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7.,Florida Statutes: Name: Phone Number: Address: In addition to himself or herself,Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. Phone number of person or entity designated by owner: Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the contractor,but will be 1 year from the date of recording unless a different date is specified) WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13,FLORIDA STATUTES,AND CAN 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 LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my knowledge and belief. (Signature of Owner or Lessee,or Owner's or Lessee's Authorized Officer/Director/Partner/Manager (Signatory's Title/Office) The foregoing instrument was acknowledged before me this day of-6— , 2011, By�e! i,�.i CUst�l as l J(f7ef— for U9 1 ame of on Type of authority(e.g.officer,trustee) Party on behalf of whom instrumen as executed � v'e�•., JOSEPH 8:HH460 Per nally known_or produced Identification ✓/ (Signature�af Notary Public-State of Florida) ' ` Notary Public.SFlorida Commission xcEL p�lue�(Print,Type,or Stamp Commissioned Name of Nota Q. My Comm.Expire1 2Y� f Identification produced Bonded through Nationry Assn.