HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: !i l I 1 - 04V
Building Permit Application
Planning and Development Services
Building and Code Regulation Division ;
2300 Virginia Avenue,Fort Pierce FL 34982 �I i
Phone: (772)462-1553 Fax: (772)462-1578 Commercial (Residential
PERMIT APPLICATION FOR: To Select from dropbox, click here
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Address: 3150 Naylor Terrace, Fort Pierce, FL 34982 �I
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SILVER LAKE PARK ADDN BLK 13 LOTS 16, 17 AND 18 OR 3501-2466
Legal Description: (
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Property Tax ID#: 2427-603-0198-000-2 I� Lot No.
Site Plan Name: II Block No.
Project Name: .i
Setbacks Front Back: Right Side: Left Side: .I
Re-Roof (�
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Additionalwork toe e Orme under this permit-check a appy: j
❑HVAC Ei Gas Tank ❑Gas Piping _Shutters j ❑Windows/Doors
❑Electric ❑_Plumbing []Sprinklers ❑Generator I� Roof Roof pitch
1600 11600 i
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 3500 Utilities. _Sewer❑Septic i Building Height: 14
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Name vestment LLC Name:
Address:12101 NW 18th St Company: AZ Contracting of Is Florida
City. Plantation State:FLAddress: 5731 NE 14th Ave
Zip Code: 33323 Fax:754-222-8551 City: FT Lauderdale's ` I State:FL
Phone No.754-222-8550 Zip Code: 33334Fax: 754-222-8551
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 i
from the Owner listed above) State or County License: 0CC1328669
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
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DESIGNER/ENGINEER
Applicable MORTGAGE COMPANY: Applicable
Name: Name:
Address: viorTerrace FortFier�e_EL34982 Address:
City: Pia� State: City: u erdale State;
Zip: Phone Zip: Phone: i
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: ; , i Not Applicable
Name: Name:
Address:5731 NE 14th Ave Address:
City: City: q
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 thepermit holderito 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 wor recording our Notice of Commencement. II
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License;Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF 13--rd COUNTY OF
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 octoberj ,J20_ by
Amit Zemach Amit Zemach
Name of person g statement Name of person king statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification"
Produced Produced
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(Signature'of lic-Statee�fl7�tdlilP�i (Sign ut ; fP(}otary Pub91��N�$9f Florid )
SrA oe : �,o: Notary Public State of Florida
roe i, Notary Public-State of da
=••� ^•€ Commission#G pQ�p = • lCommissron#GGO66000
Commission N
Q: m.Expires 'L021 Com � Au�rr22,2021 eal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE I
COMPLETED
Rev.8/2/17 I j
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