HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONf
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
SCANNED
BY
St. Lucie County
Permit Number: ft�AOVS
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 Residential
PERMIT TYPE: Residential Alteration
PROPOSED IMPROVEMENT LOCATION:
Address: 6212 Emerson Ave
Property Tax ID #: 1301-609-0052-000-5
Site Plan Name: N/A
Project Name: TIRPAK
DETAILED DESCRIPTION OF WORK:
KITCHEN RENOVATION
CONSTRUCTION INFORMATION:
QeceNeo
JApI.2g10%
5 KLudeou tty
Cpc
per
x
Lot No.8
Block No. 5
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 19�: S'00. 4511�
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameDAVID TIRPAK
Name:ROBERT FRANKLIN
Address:6212 EMERSON AVE
Company:TROPICAL DREAMS RENOVATIONS
City: FORT PIERCE State: FL
Zip Code: 34951 Fax: N/A
Phone No.772-465-4056
Address:241 THOR AVE #5
City: PALM BAY State: FL
Zip Code: 32909 Fax: 321-327-7936
Phone No321-327-2978
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-MailTROPICALDREAMS11@GMAIL.COM
State or County License CGC1 516207
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
,;
SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
Address:
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY:
Name:
Not Applicable
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 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
"YARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
ignatLi?e(of Owner/ Lessee/Contractor as.Agentfior Owner
Signature Contractor/License Holder
STATE OF FLORIDA
a ✓ems
STATE OF FLORIDA
BREVARD
COUNTY OF """ beE n J n n )q 1
COUNTY OF
The forggoing instrument was acknowledged before me
d day /+� A by
The f rgoing instru n wa acknowlecig fore me
day C by
this of fg" 201a
thisof 20•
DAVID TIRPAK
ROBERT FRANKLIN
Name of person making statement.
Name of person ma 'n statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
n
(Signature of otary Public -State of Florida )
(Signature of
•�:F• Pu'°•; CATHIE LEE SML
Commission No. �•` H0r. IaG 15fi771�
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Commission No.
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Myfarm. Erdaes Jan27.2022
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Rev.2/7/19