HomeMy WebLinkAboutBuilding Permit Application F,
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED, 1' 1
Date: Permit Number:
Kol
I i
•
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 APPLICATION FOR: To Select from dropbox, click here
Wonj,
Amar• _� _ _a _ .., _
Address: 3148 Naylor Terrace, Fort Pierce, FL 34982
Legal Description: SILVER LAKE PARK ADDN BLK 13 LOTS 16, 17 AND 18(OR 3501-2466)
Property Tax ID#: 2427-603-0198-000-2 I Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
;
A"
Re-Roof SVIl le-S
I '
...2'az'M �. .a`YDA �_ ...hoc`3+h*_ n 'li`�•i c5M -.�4". Z;.
Additional work to be nertormed under this permit–check a apply:
HVAC Gas Tank ❑Gas Piping _Shutters ElWindows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
� r I
Total Sq. Ft of Construction: 1600 S Ft.of First Floor:' 1600
Cost of Construction:$ 3500 Utilities: Sewer —S ptic j, Building Height: 14
NO
Name ZH Group Investment LLC Name:
Address:12101 NW 18th St Company: AZ Contracting,of S Florida
City: Plantation State:FL Address: 5731 NEI14th Ave
Zip Code: 33323 Fax:754-222-8551 City: FT Lauderdale State:FL
Phone No.754-222-8550 Zip Code: 33334 ( ! ' Fax: 754-222-8551
I
E-Mail:azemach@gmail.com Phone No. 754-222-8550
Fill in fee simple Title Holder on next page(if different E-Mail: azemach@gmail.com
from the Owner listed above) State or County Lii ense: CCC1328669
i
If value of construction is$2500 or more,a RECORDED Notice of Commencement is re i uired.'
I .
I
I ; I
I I
DESIGNER/ENGINEER: of Applicable MORTGAGE COMPANY: Not Applicable
Name: Name: i
Address: Address:-*@4�
City: : State: City: F-Phs-leFdala ! State:
Zip: Phone Zip: Phone:
i
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:5731 NE 14th Ave Address: I
City: City: !
Zip: Phone: Zip: Phl ne:
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 holderto 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. I
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!Jn 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 oir an attorney before
commencing work or recording our Notice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contract r/License,Holder
I, I
STATE OF FLORIDA STATE OF FLORIDA,
COUNTY OF 13--rd COUNTY OF I
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 17 day of October 20— by this 17 day of October ,120_ by
I '
Amit Zemach Amit Zemach j
Name of pers,ptrmaking statement Name of perso akin'g statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
I
I
(Signature a (Signature of N 'ftBRITTANI o•4;aa v R
;o,P" e'•; ;a°,, ;NotaryPOIc-Sta f 0 a
YPU4 �Q
Commissio .°: NotaryPubllc-Stateol��dal)
i�Orr Commission No. _.•� .: mmission#G N
o_` My Comm.Expires Mar 22,2021 =�s" oe= My Comm.Expires Mar 22,2021
,I � BandedduoughNatiat�NolatyAssn. '°'.'ho1
c�.9 ,'�,'IIST40BudighNaWNotarykm.
I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
I I
I !
i ii