HomeMy WebLinkAboutDOC 2104-0814 appAll APPLICABLE INFO MUST BE
Date: 10/05/2020
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.ETED FOR APPLICATION TO BE ACCEPTED
Permit Numt
VOID
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
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Residential X
Address: I VV I v wiu AL. FUEL FICLuL:, FL 34V4/
Property Tax ID #: 2417-702-0048-000-9 Lot No. 22
Site Plan Name: THE HENSLEY RESIDENCE Block No. 3
Project Name:
DETAILED DESCRIPTION OF WORK:
Metal fence around the property
New Electrical Meter Second Electrical Meter
L 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:
Cost of Construction: $ 5,500.00
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Alex Hensley
Name: Daniel Marin
Address: 2108 S 33rd St.
Company: Alpha Design Contractor LLC
City: Fort Pierce State: _
Zip Code: 34947 Fax:
Phone No.
E-Mail:
Address: 725 NW Kilpatrick Ave.
City: Port St Lucie State: FL
Zip Code: 34983 Fax:
Phone No 772-446-5329
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
-------- --
E-Mail nicomaquin@hotrnail.com
State or County License C13C1256205
-•- -•-�••�••-�••�• •� ,•..,,C, d nowwcu rvonce or Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL' CONSTRUCTION LIEN LAW INFORMATION:
uca1l71YCn( civ%311YCCR: A IVOL HppncaDie MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone..
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: x Not Applicable
Address:
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 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 1 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 attornev before commencing work or recording vrnjr Notice of cnmmpnrPmprst
Signature of Owner/ Les ee/Contractor as Agent for Owner
'Signature of Con actor/License Ho er
STATE COLINT OF FLORIDA St. 1 Lucie
COUNTY OF
S
St. L�jCip
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COUNTYOFSTATEOFFLORIDA
Sworn to (or affirmed) and subscribed before me of
P ical Presence��or((_ Online Notarization
worn to (or affirmed) and subscribed before me of
Ph cal Prese^�e os Online Notarization
ttday of fJ tom. — 2020 by
t is day of v ( 2020 by
Name of pe son making statement.
Name of person makin statement.
/
Personally Known OR Produced Identificationy
Personally Known OR Produced Identification
Type of IdentificationFwl'i ver License
Type of IdentificatioTE—Driver License
Pr,
-presence
Prod ced
7d_._.___
ram
—�^� enee
(Signature of Nota u lic- Sta
gnature of Notary Public- Stat
Rona Barajaa ion \e . ROSA BARAJA$
.,, qdry Publi<5late of
Commission 14 w yf enneA �5 1
Commission. G6341985
ROSQ Bar 89 pe ROSA aARAJAS
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My Comm. Expires
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Aug 77,223
My Comm. Expires Aug 17,7;
onai NotaryA s
REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGR E
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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