HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I i g' Permit Number: / LI~ d1Y
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F <1R .1 n . A 4p� o
Building Permit Application 7s?)//0,„90'24
•Planning and Development Services -04 ebe
Building and Code Regulation Division cOa'cQot
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Renovation
PROP%.,,,L-1-0,11111111-"S-1,v� EMENT LOCATION - R
.. h . ... .__ . , �. a ..c �A � � '. i.�� , _. . z�.'m.__ TT"c... 4,�,.
Address: 6507 Emerson Ave, Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 8-B BLK 5 LOT 5 (MAP 13/02N) (OR 1469-355)
Property Tax ID#: 1301-610-0075-000-6 Lot No.5
Site Plan Name: Block No. 5
Project Name: Bragg-Hurricane Loss Mitigation Repairs
Setbacks Front Back: Right Side: Left Side:
DETAILED DES } IPTION OFRWORK-
"'-
Replace front door
CONSTRUCTION INFORMATION ° t ' ` _
Additional worklto bperformed under this permit—check all =apply:
CIHVAC _Gas Tank nGas Piping n_Shutters I I Windows/Doors
ElElectric ❑ Plumbing Sprinklers I I Generator �Roof Roof pitch
Total Sq. Ft of Construction: Sc. Ft. of First Floor:
Cost of Construction:$ $990.00 Utilities: _Sewer IIISeptic Building Height:
I
OWNER/LESSEE E CONTRACTOR
Name Angela&Dave Bragg Name: Jose De La Hoz
Address:6507 Emerson Ave Company: DE LA HOZ BUILDERS, INC.
City: Fort Pierce State:FL Address: 258 Del Monte Rd
Zip Code: 34951 Fax: City: Sebastian State:FL
Phone No.772-359-6704 Zip Code: 32958 Fax: 772-589-8127
E-Mail: Phone No. 772-228-9723
Fill in fee simple Title Holder on next page(if different E-Mail: hilda@delahozbuilders,com
from the Owner listed above) State or County License: CGC1514151
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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sUPPLWIENTAL CONSTRUCTION LIEN LAW IN1ORMAcTI0N ;
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable=j
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable'
Name: Name:
Address: Address:
City: City:
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 the permit 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 restrictions which may apply. 1
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 mu .e recor• =d and posted on the jobsite
before the first inspection. If you intend to obtain financing, c. suit with le •e ,or an attorney before ,
commencing work or recording your Notice of Commence •i ,
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OPI
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Signature of Owner/Lessee/Contractor as Agent for Owner Signatu -- — *"' icen a Holder
STATE OF FLORIDA STATE OF FLORID;
COUNTY OF COUNTY OF t a l�
The forgoing instrument was acknowledged before me The forj i g instru ent was acknowledggd efore me
this day of ,20_ by this I�'d ,((.._ ,20 I
ay of by
Jc ,,2- fie. Lec Ab Z
Name of person making statement Name of pers m�.ilRlfltAt— � —
Personally Known OR Produced Identification Personally Known V t R0 f.=' --0,"e l a i ub is tti tate of Fionaa
Type of Identification Type of Identification ;3: Commission k GG 200,,78
Produced Produced , '';off, . ' My Comm.Expires Mar 26,2022 I
0 Bonded through National Notary Assn.
.•.A9.-h3) I 1 i!' . I
(Signature of Notary Public-State of Florida) (Signature ota 'ublic�-cState
�of Florida)
Commission No. (Seal) Commission No. {
a ��Fl0 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17