HomeMy WebLinkAboutBuilding Permit ApplicationJun,17. 2021 2:52PM Benchmark III
No, 5594 P. 1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
date: 06/14/2021 Permit Number: M3(4" 01 a 1
Building Permit Application st �21
4ce
Planning and Development Services i2? my
Building and Code Regulation Division Commercial x Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION POR:C4ncrete' Slab
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Address: 16891 Carole Noon Lane, Port St Lucie, FL
PropertyTax ID #: 2225-211-0001�000-2 Lot No._
Site Plan Name: Map ID 22/25X Block No.
Project Name: Save the Chimps
Install a concrete slab 19'-11"x 7'-11" at 5" thick with #5 Rebar at 24" on center
New Electrical Meter Second Electrical Meter
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: 160 Sq. Ft. of First Floor: _
Cost of Construction: $ 3400.00 Utilities: —Sewer —Septic
Building Height:
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Name Save the Chimps Inc.
Name: Gregory A Hale
Company Accurate Concrete Systems
Address: PO Box 12220
City; Ft Pierce State: _
Addre55'2696 SE Market Place
City: Stuart State: FL
Zip Code: 34979 Fax: _
Phone No.
Zip Code: 34997 Fax: 772-320-0209
E-Mail:myohannan@savethechimps,org
Phone No772-320-0206
Fill In fee simple Title Holder on next page ( if different
E�Mailaccurateconcretesystemsllc@gmaii.com
from the Owner listed above)
State or County License CGC1529090
If value of construction is 2500 or more, a RECORDED Notice of Commencement Is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement Is required.
Jun.17. 2021 2:52PM Benchmark III
No.-5594 P. 2
ESR NEI� ElM[�tNEER; u...__. l
Not, Applfc8ble MORTGAGE COMPANY: '.NotApplicableName, Name;
'
Address I Address:
City:..r.. � �..._ State: __— City,
Zip,
FEE SIMPLE, TITLE HOLM' Not Applicable BONDING COMPANY: x Not Applicable
Name' --_ Name: �.
Address� Add ress-
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OWNER] CONTRACTOR IAFFIIDVIT', Application is hereby n1a'de'tc, obtain a permit to do the work and installation as indicated.
I certify that no wort, or installation has commenced }prior to the issuance of a permit.
R, Lucie County mattes no representation that is granting a ppermit will authorize %hep ' 't holder to build the subject.structure
which Is In conflict w th any applicable Herne Owners Associatlon rules, bylaws gar ang covenants that may re trlct or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions whic� may apply,
in consideration of the granting of this rorluested permit, I do hereby agree that I will, In all respects, perform the woelt
in accordance wlth'tche approved plans, the Florida Building Codes and St. Luclo County Amendments.
Thr, following building permit appilcations are eYernpt from undergoing a full toncurrency review: room additions,
accessary structures, swimming clods, fences, wall$, signs, scFeen rooms and accessory.uses to another noh-resfderitial use
WARNING t®W•NER; Your f'aliure to R60rd a Waillee of Coirihtnencarnent may rgsult'ln paVIII-0ty�ice for
IMPrnvemiAnts to your property. A No.tice of COmf�encement Pnust b'e r0corded in the-:0viblIc. 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 attorfley before corrlrmenclrjg�ydrlt or record your NotlCe of Colnfnehcetnent,
signature
as Agent for Owner
l STATE OF FLO i
COUNTYQF
Sworn to (or affirmed) and subscribed before me of
Physical PI'us a or ✓ Oniii1e Notarization
this, IL day of^ ..� 2020 by
hit�me of lyerscrt tn�t4in� sYatemerll.
Pericinally Kliowl, OR Produced I4li;nrr!'icr ioit
yfie of ir.terstirir;r t.ir,'r,
f•'r'o u .t�
n Notary Public $tale of Florida
r.'r'iIIYiIti51t ' Klmberly Jo Holmea I5r 1ji
Mf commTwgdrt GG 117612
or Expirn 07/23/2021
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re of Contra
STATE OFFLO
COUNTY CIF MIA4 Ab iia
Swo to (or affirmed) qnd subscribed before me -6f
P sical pre - e ar 4nlliie notarization
this � day of 202V by
N7rne h r _ sort m One statelnellt. T
persoclally Krimilt „!�_ Oil Produr:ed ldentifica, Mon
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},40 Notary a611a 8{el9 Ol Flonda
Jurrmbedy Jo Holmes
MY Commission GG 117012
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