HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO -MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �IV�® a,17
Permit Nu mber"
1:2021
Okil County
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Bui . ngPermit 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 CB:DG Funding
PERMIT APPLICATION FOR:
John Kuveikis JR)
P`RP1°P(lCt=f1 1'n�ADRfi\/GnAG�IT I A oTlrinl•
.Address:. �-Park�a#feet-East HamptoTrt4y-1*93T 1.5
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PropertyTax ID #::4502 501.:0199 000 2: .. .: o L t:No 13
Site Plan Name: Block No.
Project Name:;.
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New 4" thick 3000 PSI concrete -slab with fibermesh and :one # 5 rebar.
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New Electrical:M ter Second Electrical Meter (Affidavit required)
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Additional work to be performed under this permit — check all that -apply:
p g:: _Sh.utters Windows/Doors: Pond:-
.: _Mechanical: _.Gas Tank:Gas Pi:::= m
Electric _ Plumbing:: . Sprinklers _ Generator _ Roof Pitch
Total Sq'Ft of Construction: 1320 S qFt Sq..Ft. of First Floor:
11,880.00
Cost of Construction:-$ Utilities;.: _ Sewer: - _ Septic Building ;Height::
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OWN'ER�LESS ... OR., Nr C T
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Name.. John:Kuveikis(TR) :- Name:: Robert.E:Burns
Address: -9 Park Street East Hampton NY 11937 Company: BurnsAndSonsConcretelncQ_gmail.com
City: State: 'Address: POST OFFICE BOX # 2335
Zip Code; Fax:.- City: PALM CITY State: FL
Phone No. -E- Zip Cod.e:. 34991 Fax:
Mail: Phone No 772 260 3726 or 772 260 0776.
Fill iri fee simple Title Holder on next page (if different E-Mail:BurnsAndSonsConcretelnc(a�pmail:com
from the Owner listed above) State or County License 25364.
If value of construction is 2500 or more, a RECORDED Notice of Commencement:is:required; .'
If. value of HAVC is $Z 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:
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.
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 oste� on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender,or an Attorn& before commencing work or recording vnur Nntirp of CnmmPnrPmPnt
i g a ur" of;OWri�er/;Lessee/Contrac`tor o as Agent fr Owner
STATE OF FLCI(F i 5
n e
COUNTY OF _�4
rgay ffir Os scribed befptqYe ayf
S fto
P y 'cal se c Qr,�� 0 i�rization
Name of pJg statement.
Persona yOR Pr c d d fi doType
of droduce
(Signature of Nota Public- State of Florida)
?;,: AUTUMN N. BURNS
Commission No. LQ�
*; ;. WCOMMISSION #GG248769
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QK- EXPIRES:September18,2022
Bonded Thru Notary Public ynderwdleta
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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