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HomeMy WebLinkAboutPermit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 02106/2018 Permit Number: WBuilding Permit Application Planning and Development Services Building and Cade ReculGtion Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 4.62-1578 � COmrrir�i tial E�eSidential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I PROPOSED IMPROVEMENT LOCATION: I Address: 2421 KEEN RD FORT PIERCE, FL 34946 Legal Description: 36 34 39 S 20 AC OF SE 114 OF NE1/4-LESS RD AND CANAL OFNE 114 -LESS RD AND CANAL R1W- (DBK173-491: CIR COURT MIN BK Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back: Right Side DETAILED DESCRIPTION OF WORK: DEMOLITION • M e k CONSTRUCTION INFORMATION: AdclAsonal work to be ertormed under this permit— cI F JHVAC E] Gas Tank ❑Gas Piping 11 Electric] ❑ Plumbing Sprinklers Total Sq. Ft of Construction: 2,102 ALSO DESC AS: S 653.88 FT OF SE 1 2555-1158:2823-1212: Lot No. Left Side: all that apply: ❑ ShuttersM❑ Win /Do Generator Roof Roof pitch S Ft. of First Floor: IM2 Cost of Construction: $ 6,500 Utilities:- Sewer L-1 Septic 0 Building freight: OWNER/LESSEE: CONTRACTOR: I Name CALICO AMALGAMATED PROPERTIES, LLC Name: ANGEL VARGAS i Address:284 SOUTH ISLAND Y Company: BUILT TO LAST CONSTRUCTION SERVICES, CORP Address: 3396 NW 151st TER City: GOLDEN BEACH State: FL Zip Code: 33160 Fax: Phone No. City: MIAMI GARDENS State:FL Zip Code: 33054 Fax; 305-888-6173 Phone No. 305-883-7047 E -Mail: Fill in fee simple Title Halder on next page (if d ferent fifrom the Owner listed above) 40 E -Mail: BTLCORPOBELLSOUTH.NET State or County License: CGC 064584 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL. CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name. Address: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: 0—Not Applicable Name: BONDING COMPANY:1140011— Not Applicable Name: Address: City, ,address: city: Zip: Phone: I 7ip: 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 the pe"fifnit holder to build thetect Pri,wu"' 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 addition accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residentiaV 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 an the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice of Commencement. Rev. 8/2/17 0M lr F 997380 e 2020 ntractor/License Halder 5ignat of ner/ Lessee/Contractor as Agent for Oviner STATE OF FLORIDA STATE OF FLORIDA " COUNTY OF iY mill'{ I t COUNTY OF A The for omg instrument was acknowledged efore me day Pfb r'{, aI[ The forgoing instrurn nt was acknowledged before me this � day of 2016 by this of , , zo y U rCn+ C r0 S I i 0 _ Rfrl t,,Vo 05 � Name of person making statement Personally Known .'�( OR Produced Identification Name of pqrsog making statement Personally Known _ � OR Produced Identification Type of identification Type of Identificatio Produced _ Produced -,-W I =• r a• SI nature of NotaryPublic- State F LI EU (�}}��^^�� * t' EXPIRES June1,2020 L t of Notary Public- State of Florid Y LI©AN.c Commission No. F"1"I ;, BondeuThruNotaryPsi so „;,• t3. l f 1 W� "1 ( � ' my -_� Ju EXPIRES: Bonded Thru Notary REVIEW -0 FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTS REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 0M lr F 997380 e 2020