HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: —is �,� Permit Number:3105-1 10
RECEI' D 14AR 22 2017
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 X
PERMIT APPLICATION FOR: Concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 2804 Juanita Avenue
Legal Description: SHERATON.PLAZA-UNIT THREE REPLATLOT 939 (OR 3830-1814)
Property Tax ID#: 1432-806-0007-000-3 Lot No.139
Site Plan Name: Sheraton Plaza-Unit 3 Block No. n/a
Project Name:
Setbacks Front'25' Back: +/-50' Right Side: +(-21' Left Side: +/-10'
[DETAILED DESCRIPTION'OF WORK:
Proposed 25 foot x 10 foot concrete patio slab in back yard. See attached Plot Plan.
';000 PST ,In;
CONSTRUCTION INFORMATION: '
Additional workto flasTank
orme under this permit—check a appy:
El HVAC ❑Gas Piping _ShuttersL1Windows/Doors
❑Electric '❑ Plumbing []Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: N/A. S Ft.of First Floor:
Cost of Construction:$ 750.00 Utilities Cn Sewer[]Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Uriel G. Rodriguez Name: Owner/Builder
Address:2804 Juanita Avenue Company:
City: Fort Pierce State:FL Address:
Zip Code: 34950 Fax: City: State:
Phone No.772-318-5751 Zip Code: Fax:
E-Mail:roberto-cabrera@hotmail.com Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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
WARNING 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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M0 Ob'cAf Or?, s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5A -L a c i e- COUNTY OF SSA
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this2 day of Matic Vi 20 Ilby this Z� day of AAaac 20 11- by
� ober-}o �'abyed� �{ abe! -�o Ca 'bfe rZ
(Name of person acknowledging) (Name of person acknowledging)
/44 Z944
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
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Personally Known OR Produced\\lc #1 11//� _ Personally Known OR Produce LiAi@
Type of Identification Produced �_�0 -1x i Type �1�—A,,• 't9�g
rc 9 l T e of Identification Produced P SSI
i tY � �c �
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Commission No. �F�� ���? er�9�9: Commission No. FF 93; 6$S +* al) N;
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REVIEWS FRONT ZONINGPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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