HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 8-24-18ALL APP hCAB FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �u9ust 018 **0 Permit Number: '
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Building Permit Application 4 20I
=Plannigevelopment Services
Buildin 'and Code Regulation Division nty, Permitt'
2300 V' ginia Avenue, Fort Pierce FL 34982
Phon (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PER IIT APPLICATION FOR: Building
PROPjOSED IMPROVEMENT LOCATION:
Addre I:_ 3 Eleven Mile Road, Fort Pierce, FL 34987 S757� 6 e\1e M s `� a i'Lrce M
Legal Ilescription: 28 35 39 E 30 AC OF SE 1/4 OF SW1/4-LESS N 840 FT - ANDS 4 AC OF W10 AC OF SE 1/4 OF
SW 1 14-LESS El FT- (16.13 AC) (OR 3376-25711)
Prope y Tax I D #: 2328-343-0000-000-7 Lot No. N/A
Site P n Name: Shiffer Residence Block No. N/A
Pro'e t Name:' J Shiffer Residence -- -
Setb..cks Front Back: Right Side: Left Side:
ILED DESCRIPTION OF WORK:
Con Itruction of a single family residen'idi muse. Home is approximately 3,121 SF (Under Roof) and
will ie 3/2/2.
CONSTRUCTION INFORMATION:
itiona wor to e e orme under this permit —check a apply:
i HVAC Gas Tank ❑Gas Piping Shutters ❑ / Windows Doors
I Elect-
ric ❑✓ Plumbing ❑Sprinklers ❑ Generator g Roof 6/12 Roof pitch
To al Sq. Ft of Construction: 3,121 SF S . Ft. of First Floor: 2,400 SF
225,000 Septic Building Height: 20'
Colt of Construction: $ 3� (:,�A •1� Utilities: Sewer
OWNER/LESSEE;
CONTRACTOR:
N me David Lloyd
A dress: 3803 Eleven Mile Road,
Name: Charles D. Kerns
Company: Kerns Construction & Property Management Corp.
Address: 540 NW University Boulevard, Suite 204
City: Port St. Lucie State: FL
Zip Code: 34986 Fax: 772-209-7700
Phone No. 772-985-5015
C,ty: Fort Pierce State: FL
dip Code: 34987 Fax:
one No. 772-528-2034
-Mail: david@twowayradiogear.com
ill in fee simple Title Holder on next page ( if different
Irom the owner listed above)
E-Mail: kerns02@att.net
State or County License: FL CGC 059365
value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
s
SUPPL tIMEDWAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNrrfR/ENGINEER: _ Not Applicable
Nam e: l�scon Baruch & Assoc., Inc.
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Add reS 178 Beacon Lane
jI�:
City: Jugiter State: FL
Zip: 33410 Phone 561-768-6224
I
City: State:
Zip: Phone:
FEE SIPPLE TITLE HOLDER: _ Not Applicable
i
Name: ;avid Lloyd
BONDING COMPANY: Not Applicable
Name:
Address: 3803 Eleven Mile Road
Address:
City: Fo4 1`,erce
City:
Zip: 34d,06 Phone:772-528-2034
1
Zip: Phone:
OWNEf -/ 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. Lucieount makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is kcon flict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure's 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 accor lance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The follo I ing building permit applications are exempt from undergoing a full concurrency review: room additions,
accesso structures, swimming pools, fences, walls, signs, screen rooms and accessory uses -to another non-residential use
WARN G TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impro ments to your property. A Notice of Commencement must be -recorded and posted on the jobsite- - -
beforetthe first inspection. If you intend to obtain financing, consult with lender or an attorney before
nr rinn %Ainr4 nr rcrnrrlina vniir Nntiro of rnmmPnrpmPnf
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Signare of Owner/ Lessee/Co actor as A ent for Owner
Signature of Contractor/Lic se Holder
STA IIE OF FLORIDA
STATE OF FLORIDA
COUI TY OF SAINTLUCIE
COUNTY OF SAiNTLUCiE
The forgoing instr ent was acknowledge before me
thisJLI�Ilay of 20 / by
The forgoing instruTqnt was acknowledged before me
this o2o2n141ay of 20�& by
U
Charles D Kerns
Charles D Kerns
Nam Nme of per on making statement
Pers I Wally Known OR Produced Identification
Typ lof Identification
Name of person making statement
Personally Known_ OR Produced Identification
Type of Identification
Pro uced
Produced
(Sign re of
Commission N
-
(Sig ture of
Co mission No
-
, . LN U J. TLER
'�� •': MY COMMISSION y8i� 3607
=., •e, �r' EXPIRES Qctober 31 2019
4401)398-01W FWW2NoterySar*v.corr
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,�' `9q 1 J. TTLER
�� •'i MY COMMISS"#If F923607
EXPIRES October 31 2019
(4or 398-0103 Floridal4m sarvice.con,
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Rev.1,0/2/17