HomeMy WebLinkAboutBuilding permit , pg 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:10/25/2021 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial XX Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 13406Harbour Ridge Blvd.,Palm City, FL34990
Property Tax ID #: 4436-605-0003-000-9 Lot No.
Site Plan Name: 13406 Renovations Block No.
Project Name: 13406 Renovations
DETAILED DESCRIPTION OF WORK:
Interior condo renovation per plan, 2 bedrooms, 2 bathrooms, and kitchen
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 XX Windows/Doors _Pond
XX Electric XX Plumbing _Sprinklers _Generator _Roof Pith
Total Sq. FtofConstruction: Sq. Ft. of First Floor: 1559
Cost of Construction: $ 89,000.00 Utilities: Sewer Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Dr. & Mrs. Fred Theye
Name: Robert Dunlap
Address: 13406 NW Harbour Ridge Blvd
Company: Rubin Custom Homes
Address: 4253 SW High Meadows Ave
City: Palm City State: FL—
Zip Code: 34990 Fax:
City: Palm City State: FL
Phone No.772-344-64556
Zip Code: 34990 Fax: 866-480-7498
E-Mail: ftheve@Pmail.com
Phone No 772-283-0553
Fill in fee simple Title Holder on next page (if different
E-Mail arubincustomhomes@gmail.com
from the Owner listed above)
State or County License 1529565
ifvalueofconstruction is2500or 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
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
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.
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 toyour properthty. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on e 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
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this day of 120 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida)
Commission No. (Seal)
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Rev 5/20/21
Name-
Address -
City, State:
Zips Phone
PEE SiMPLE TITLEHOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone
MORTGAGE COMPANY. Not Applicable
Name:
Address, Sfiate-
City:
Zip: Phone'
BONDING COMPANY, ,_ _,Not Applicable
ii!ame: -
Address: -
City:
Zip; Phone:
OwNERJ CONTRACTOR PaFROVIT: Application Is hereby made to obtain a permit to do the worl<and installation as indicated.
I certify that no work or installation has commenced Ariorto the issuance of a perrnit.
5t. Lucia County mattes no representation that is granting a permit%411 authorize the nemilt hoider to build the subject structure
which is In conflict with an applicable Home Owners Association rules, bylaws or and covenants that may, restrict or prohibit such
structure. Please consult with your home owners Association and reviewyour deed for any restrlcilicT lch may apply,
in consideration of the granting of this requested permit I do hereby agree that € will, in all respects, perform the work
Jr, accordance wlth the approved plans, the Florida Building Codes and Si:. Lucie CourttyAmerdments.
The foilowing building permit applications are exemptfTom undergoing a Full concsrrency review: room additions;
accessory structures, sviimming pools, fences, walls, signs, screen roorrrsand accessory usesto another non-residential use
WARNING TO OWNER- Your falture to Record a Notice of Commencement May result in guying twiceli for
improvements to your property; A Notice of Commencement must be recorded in the gubItc records of S;.
Lucie County and-ii 'fie`E�ofi"t� Qobsite before the first inspection. if you intend to obtain financing, consult
_ _
loll r
STATE OF FLORIDA
COUNTY 0
mto (or affirmed) and subscribed before me of
physical Presence or _ online Notarization
this LL- day of >~ 202 by
Name of person making statement.
Personally Known t", OR Produced Identifcation
Type of identification �,--•4
Produ d
.. ..e., KELLIEHO;-r"''
- :�� t8 iiC •State o` =.oriCa rt;
u
(Signature a Q c o ; µy Comm xpires
*�ati na tiotary ass
Commission o,
STATE OF FLORIDA
Cr UVI Fy 0 i�l st I l 'ufi i
Sworn to (or affirmed) and subscribed before me of
_X-Physlcaf Presence or online Notarization
this L_dayof s s -- z01 by
Name of person making statement -
of, Produced Identification
Type of Identification
Produced,,_ _ �--I -- -
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4 , ► \ it i"° ••. KELLIE H
Commission
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