HomeMy WebLinkAboutDOC 2012-722PERMIT APPLAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/31/20 Permit Number:---?ev' -6749-
9 L(o RECEIVED,
o DEC 3 1 2020
Building Permit Application Permitting Department
Planning and Development Services St, Lurie Count,
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: Single Family Residence
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Address: 5050 N Highway AIA, N Hutchinson Island, FL 34949
Property Tax ID q: 1414-220-0005-000/5 I L f �� Lot No.
Site Plan Name: SPA SITE PLAN Block No.
Project Name: Walpent Residence
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Completion of residence
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New Electrical Meter Second Electrical Meter
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Additional work to be performed under this permit— check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond
Electric 3' Plumbing _ Sprinklers _ Generator Roof 2:12,4:12 Pitch
Total Sq. Ft of Construction: 5399 Sq. Ft. of First Floor: 4087
Cost of Construction: $ in process Utilities: —Sewer _Septic Building Height: 33It
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Name Mark Walpert
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Name: Owner / Builder
Company:
Address:4235 N Highway A1A, Apt 11
City: Hutchinson Island State: _
Address: -
City: State:_
Zip Code: 34949 Fax:
Phone No. 203-778-9950
Zip Code: ;. Fax:
E-Mail: markwalpert@gmail.com
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
State or County License
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.
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY: X
Not Applicable
Na me: wi11lann P Stoddard
Name:
Address: 1717 Indian River Blvd, suite 201
Address:
City: Vero Beach
State: FL
City:
State:
Zip: 32960 Phone772.770•9622
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x
Not Applicable
BONDING COMPANY: x
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.
1 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 or an attornev before commencine work or recordine vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SAr Li y t.-e
COUNTY OF
Swop to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or i Online Notarization
Physical Presence or _ Online Notarization
this 'il day of 7S& c 2020 by
this day of 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced J
Produced
was
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(SigrTature of Notary Pu li tate of Florida)
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(Signature of Notary Public- State of Florida )
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Commission No. (Seal)
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Commission No. (Seal)
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REVIEWS
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VEGETATION
SEA TURTLE
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REVIEW
DATE
Names
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RECEIVED
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DATE
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COMPLETED
Rev.5/b/R0