HomeMy WebLinkAboutBuilding Permit App - Pederson All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: _ Permit Number:
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c Y___ 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: Interior Remodel
PPOPOSED IMPROVEMENT WCATIOW
Address: 1507 NW Sawgrass Way Palm City, FI. 34990
Property Tax ID#: 4426-815-0060-000-0 Lot No.
Site Plan Name: Harbor Ridge / Button' Village Block No.
Project Name: Pederson Remodel
DETAILED DESCRIPTION QF WORK: ,
General Interior Remodel / Please see attached scope of work letters for details
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMAT 0 .
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
X Electric X Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: No change to existing Sq. Ft.of First Floor:
Cost of Construction:$ 226,000.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE. C( NTRA T{ R:
Name Cortney & Sidwell Pederson Name: Ed Gribben
Address: 6272 Addington Court Company: Gribben Const. DBA Dreammaker Bath&Kitchen
city: Eden Praire State:Mn Address: 6118 SE Federal Hwy
Zip Code: 55346 Fax: City: Stuart State:FI
Phone No. Zip Code: 34997 Fax: (772)286-2072
E-Mail: Phone No (772)288-6255 / Dave (772)260-9106
Fill in fee simple Title Holder on next page(if different E-Mail davP cirPammaker-stiiart_cam
from the Owner listed above) State or County License CGC1507879/23204
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 INFORMATIOW
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Don Nueile Name:
Address:11634 SW Rowena Street Address:
City: Port St Lucie State: Fl City: State:
Zip: 34987 Phone(561)629-6975 Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: xNot 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 r an attorney before commencing work or recording our Notice of Commencement.
J, 'i"y
Signature of wner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Martin
Sworn to(or affirmed)and subscribed before me of X Physical Presence or Online Notarization
this 2nd day of September 2021 by
Ed Gribben
Name of person making statement.
Personally Known X OR Produced Identification
T e of Identification P ced
1
(Signature of Notary Public-State of Florida) p. DAVE D.MORELLI
Commission#HH 110877
Commission No. HH110877 (Seal)
Expires May 8,2025
B=W Ttn Troy Fain Insurance NO.385-7019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 5/20/21