HomeMy WebLinkAboutBuilding Permit Application !
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/16/2018 Permit Number: I
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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 1
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PROPOSED MPROVEME°NT LOCATION. ! ` �. ;. .
Address: 5502 PALEO PINES CIR, Fort Pierce, FL 34946 it
Legal Description: HOLIDAY PINES S/D-PHASE I-LOT 47(MAP 13/12S) (OR 2913-2049)
Property Tax ID#: 1312-500-0048-000-4
Lot No.
Site Plan Name: i ! Block No.
(Project Name: Driveway Replacement
!Setbacks Front Back: Right Side: Left Side: '
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DETAILED DESCRIPTION
QF WORK
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Replace Drive Way (concrete)
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CONSTRUCTION INFORMATION Ck '
Additional work to be nerformed -under this permit-check all appy: i
HVAC _Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
71
Electric 0 Plumbing ❑Sprinklers Generator ✓i Roof
Total Sq. Ft of Construction: 600 Sq. Ft. of First Floor: '600 ;
2,150.00 I !
Cost of Construction:$ Utilities: _Sewer Septic i Building Height:
011VNER%LESSEE' CONTRACTOR ;,'. 5F J
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Name Ghazanfar Saeed Name: Roderick Waller
Address:5502 PALEO PINES CIR Company: Sunrise City CHDO, Inc.
City: Fort Pierce, State:FIL Address: 3550 Okeechobee Rd
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No.772-359-3936 Zip Code: 349471Fax: 772-907-0420
E-Mail: Phone No. 772-201112850
Fill in fee simple Title Holder on next page(if different E-Mail: rodwaller1@gmail.com
from the Owner listed above) State or County License: �� -C��-I
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if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTIO:N{LIEN LAW INFORMATION �= , 9 iK4
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: ; ' -Not Applicable
Name: Name:
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Address: Address:
City: State: City: .I i State:
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: I _Not Applicable
Name: Name:
Address: Address: !
City: City: I
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 thepermit 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 restri(tions 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. !
he following building permit applications are exempt from undergoing a full concurrency lreview::room additions,
laccessory 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 dr.'an attorney before
commen-cing work or recording our Notice of Commencement.
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V��A' s
_Signature of Owner/L see/Agent Signature ontracto /License Holder
STATE OF FLORID STATE OF FLORIDA(
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this\\o day of 20 Eby this day of I ! 20 by
(Name of person acknowledging) (Name of person acknowledgirig)
(Signature of Notary Public-StAe of Florida) (Signature of Notary Public- tate of Florida)
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Personally Known ced,l roti.icati. Personally Known_ ed IAentificatio
Type of Identification oLASHAHNA INORAM Type of Identification odLASHAHNAINGRAM
Notary Public-State of Florida ;+° *��: Notary Public-State of Florida
Commission No. i• ' MrCo(�agxplres Dec 20,2098 Commission No. =' My Cor��alrires Dec 20,2018
Commission#FF 1`172491 % OFFS°PCO, Commission#FF 177249
�''��°�n�•`'�, Bonded throunh National Notary Assn. i. '""�"T Bonded through National,Volar;,Assn.
Revised 07/15/2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA,TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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COMPLETE
INITIALS 1
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