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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLI�ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED DJe: q � 1011 Permit Number: Q Building Permit Application ing and Development Services ng and Code Regulation Division Virginia Avenue, Fort Pierce FL 34982 e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential V PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line P IE D 1 10�.qk. M_ 6 E M IdN:"- Addrrss: *r)i to- 'N-1 Ve L g _(3Ff z4o e aj�Description: rkyj ffs V ka se- L Prop i �rty Tax ID 604� - oco - Lot No. Site [Ilan Name: '-)<f C 6kMVal.f'15 Block No. i Project Name: Set `1 : �cks Front Back: Right Side: Left Side: DE ON_,C1F WORK _5 04 �cc r\ -C) 7 CO sTRU'."� N*" CTIdWiNFORMAT Additional work to bepertormed under this permit -check all apply: 11 HVAC LJ Gas Tank 0Gas Piping Shutters Windows/Doors Electric ❑ Plumbing OSprinklers ❑ Generator L=1 Roof Roof pitch Total lSq. Ft of Construction: Sc Ft of First Floor: Cost i Sf construction: $ Utilities., SewerEl Septic Building Height: REMESSEE: -CON TRACTOR, m6(c) 1) Nam. LJ_ I VIV Name: Address: 4-;�01 F_dYc' -or Company: -b—Rn(_'C City: 1� P4-'_PieAZ e, (--C State: Address:Z2-Db Skk-P V)C4'l-�Ctr6C Zip Code: 72� Ll 9t Fax: City: Vby-f S-� Statel z Phor No. . Zip Code:__�'_fcl 1� 3 Fax: E -K ]i i 1: Ci AM e, evi+ C�P_) JAYA1 C -d VI Phone No."9-01 -Ito21090 Fill iri fee simple Title Holder on next-bage ( if different E -Mail r-r)6enik4o (2vYiq_t fro4the Owner listed above) State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. I S.UPP1LE ME NTAL CONSTRUCTION LIEN LAW.INFOR IVlATION "'- DESIGNER/ENGINEER: OR Produced Identija "o ✓ _Not Applicable MORTGAGE COMPANY: Name: Identification Pr �, " Name: Adore s: Address: City: I State: City: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: /Not Applicable BONDING COMPANY: Name Name: Addre s: Bontletl Thm Address: City: I City: Zip: 1I Phone: 11 Zip: Phone: that no work or installation has commenced prior to the issuance of a permit. ✓Not Applicable State: ,,/Not Applicable St. Luci .Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure which isl in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structufe. 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 acco dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The foil wing building permit applications are exempt from undergoing a full concurrency review: room additions, access ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for impro ements 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 comm nncinp work or recording vour Notice of Commencement. 11 \\ " S Signatuto of Owner/Letsee/Cod,{ractor as Agent for Owner Signature of Contractor/License Hol STATE OF FLORIDA ��STATE OF FLORIDA GOUNTYOF ��t l ('tom COUNTY OF �� I i� Cie The fo rgoing instrum�nt.wa acknowledged before me thi��{+ryp day-}�o�)fv 1�.�X�i 20 by l O CAU f� t/�7 (Name I of person adn�o�wll dging%) (Signal re of Notary Pub " - State of Florida ) The fooing mstru ent s®acknowledged before me this —day of i"I .20 by (Name/oaf persoc(ackno4ledging ) (Signatu(re of Notary Public- State of Florida ) Person Illy Known OR Produced Identija "o Personally Known OR Produced Identification Type ol` Identification Pr �, " racnvco Type of Identification Produced. Commission No. µ �* ` MY COMMISSION «FF'.5i'27s EXPIfi@a`E;`F tember4,2C7 o ..,rye, Commission No. I ` ` McLINl1AWEAFF1 MY, FF 157216 { e�:.r 'I Beadd Th, Waq Nbic Uneerx z: . EXIRES: Septemher4 2078 Notary Pobfic Untlenvn;ars , ='"u Bontletl Thm I. Revi Idled 07/15/2014 REVIdws FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE II COMPI ETE INITIAL County Certification Number. 29784 Planning & Development services M Building & Cane Regulation Division 2300 Virginia Ave Ft Pierce, FL 34962 Phone: (772) 462.1672 Fax: (772) 462-1148 httpl/vm lucieco.orgiplanning/Contract_licen.htm Duguay, Aldo Joseph R D -Fence Enterprises Inc 621 Sw Estate Ave Port St Lucie, FL 34953 Class Code: FENCE License Type: COUNTY CERTIFICATION This Competency Card, issued by the St. Lucie County Contractor Certification Division, authorizes work for the Class Code stated, for the unincorporated areas of St. Lucie County. It does not authorize work for the City of Ft. Pierce, St. Lucie Village or the City of Port St. Lucie. It is the Contractor's responsibility to maintain this card in a current status by providing a Certificate of Insurance, current address and telephone information, and renewing this card annually as required. Expiration Date: 9/30/2017 Danielle Williams Contractor ID Card to fit, then fold in half --——————————————————————————————————— IDENTIFICATION CARD ounty Certification Number 29784 'lass Code: FENCE Contractor Licensing: (772) 462-1673 his is to certify that DUGUAY, ALDO JOSEPH R, O -FENCE Contractor Fax Line: (772) 462-1148 NTERPRISES INC has been issued a County Certificate in St. Automated Inspection Line: (866) 284-1280 ucie County, beginning on 7/20/2016 and ending on Inspection Line: (772) 462-2172 130/2017, unless license is revoked. Danielle Williams Authorized Licensing Official I ----------------------------------------------I