HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0\b a Permit Number:
9V 1QLu RECEIVED
o 17 Qw"*' SEP 10 2021
Building Permit Application
Planning and Development Services M9Illi p ry
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: �_eso O � _ oA
PROPOSED IMPROVEMENT LOCATION:
Address: I�,� NL' 'TSvn A�zI �c�� S L��� �C- 3Lf.c S
Property Tax ID #: _14 k 'I - S (0 0 ' 0 222t o O O Lot No. -7
Site Plan Name:
Block No. -7 (,o
Project Name: 1 9 C7 (�'� fij A S o•� /�� � � ��c,�' � �y O4-
DETAILED DESCRIPTION OF WORK:
T�� d� e�c;s�:��, co o�(In� �u4-er-a (S Cs�;•-�,�,r ��c.�,
r
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 I I Z Pitch
Total Sq. Ft of Construction
C GI G C.
Cost of Construction: $ 1-3, 8 Y S
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height: q . S
OWN. __, _
CONTRACTOR:
Name C�1!!' 1 Z-o/1 koyk"
Name: nu,i c.
Address: 190 Pe T�� �s on Avg
City: Rr,+ Sk . State:
Zip Code: 34g83 Fax:
Phone No.�, �1Z1 6Z (O - -2- 3 E-
Company: DO�� 2ooL( <)
Address: PO 60�-
City: Poy+ S+- �u`� State: ;-cam
Zip Code: 3`}•19 8 Fax:
Phone No ( -I1Z1 3 3 Z --3 to 7
E-Mail Joi --\ Co O Lo'h
State or County License 6033z SI I / 3 Z I
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 your Notice of Commencement.
Signature of Owner Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTYOF Sk.
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this 1 0 day of 'SQQtk 201,.1 by
Name of person making statement.
Personally Known OR Produced Identification
e of Identification Produced
(Signature of Notar P
""o •..• DEANNA GIVENS
,ll
Commission NoT1 ot��¢lic - State of Florida
HH 086359
Commission #
Comm. Expires Jan 28, 2025
through National Notary Assn.
EL
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev 5/ZU/Z1
MICHELLE R. MILLER, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 4921676 OR BOOK 4682 PAGE 1335, Recorded 09/-W 1%21 01:16:46 PM
Permit No. _
State of Florida
County of St. Lucie
SEP 1
NOTICE, OF COMMENCEMENT St Lucie County
Permitting
Tax Folio No. 3419-560-0024-000-0
The undersigned hereby gives notice that improvement will be made to certain real property, and In accordance with Chapter 713, Florida Statutes,
the following Information is provided In this Notice of Commencement.
Legal Description of Property: (and street address if available):
RIVER PARK -UNIT 9-PART 'A' BLK 76 LOT 7 (MAP 34/28N) ((OR 927-1013)
General description of Improvement: Reroof
Owner Information or Lessee Information if the Lessee contracted for the Improvement
Nam
o C:hr+nrl A Inn kncki
Address 160 NE Tunison Ave Port St Lucie FL 34983 _
Interest In property: N/A
Name and address of fee simple titleholder (If different from Owner listed above):
N/A
Contractor's Name: Doing Roofina, Co.
Contractor Address: PO BOX 881491 Port St Lilc]e F1 '14988 Phone Number: (833) 367-6630
Surety (if applicable, a copy of the payment bond is attached): Amount of bond: 5 N/A
Name and address: N/A Phone number: /A
Lender Name: N/A Phone Number: N/A
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(I) (a)7., Florida Statutes: -
Name: N(A Phone Number: N/A
Address: N/A
In addition to himself or herself, Owner designates N/A of N/A to receive a copy of the
Lienors Notice as provided in Section 713.13(1) (b), Florida Statutes.
Phone number of person or entity designated by owner: N/A
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) N/A
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 I, 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 1 have read the foregoing notice of commencement and that the facts stated therein are true to the best of
myJWowledge and belief
llii Sf1�� r�
(Signatory's Title/Office)
STATE OF FLORIDA
COUNTYOF--,. L LTA
Officer/Director/Partner/Manager
The foregoing Instrument was acknowledged before me by means of O physical presence or O online notarization this C( day 06s 0-eN"'N
2021_by C e.1,A� f _ 20r,)YOSC' I who is personally known to me or has produced i'l m: �n d✓C,:UM b as Identification.
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`S'
iA NKL1M TER"
N.wv BW Ile - st t� d BIanA� -
INOTARIALSEAL] e e = --
tarBarlBtBn.wwtrY�• ARV�e.lorida
IN EREBYCERnFV THAT THIS DOCUMENT IS A TRUE AND CORRECT COPY OF AN OFFICIAL RECORDOR AIVElb, Digitallyy si(�]5ned by The Honorable Michelle R. Miller
DOCUMENTAUTHORIUD BYLAW TO BE RECORDED OR FILED ANDACFUALL\' RECORDED OR FILED IN Date: 20 21 . 0 J . 10 13 • 18 • 10 - 0 4 • 0 0
THE OFFICE OF THE ST. LUCIE COUNTY CLERK OF THE CIRCL'ITCOLIRTL ow ReaSOn Ele Ctron l Call Certified CO
THIS DOCUMENT MAY HAVE REDACTIONS AS REQUIRED Rl' LA". Y Copy
T,nr.tinn• 9n1 .gn"th TnriiAn Pilrar nr. P—t, Pip r-p. FT. '24Q5n