HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �% /g Permit Number:
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: Window/door
PROPOSED IMPROVEMENT LOCATION:
214 SE Camino Street, Port St. Lucie, FL 34983
RIVER PARK -UNIT 3- BLK 28 LOT 31 (MAP 34/22S) (OR 2055-664)
Legal Description:
Property Tax ID #..3419-515-0220-000-4
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side
Left Side:
Remove and replace overhead sectional 16'X 7' garage door.
HVAC H Gas Tank
nElectric 1:1 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1,550.00
Lot No. 31
Block No. 28
under this permit - check all tbat apply:
Gas Piping 0 Shutters Windows/Doors
Sprinklers F]Generator Q Roof Roof pitch
Sq. Ft. of First Floor: _,
Utilities SewerM Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
y Maloney
Name: even a yjasze
99 app ire errace
Company: slot onstructlon oo Ing
rAddress:
t. ucle State:
Address: 18 2 row erry rive
Zip Code: Fax:
Portt. Lucie
City: State:
-666
3 9 3 7 -618-666U-
Phone No. -6 - 469
Zip Code: Fax:
772-418-8809
7 -41 9
E
Phone No.
-Mail:
kevin exec slorconstructlon.net
Fill in fee simple Title Holder on next page ( if different
E -Mail:
521911
from the Owner listed above)
State or County License:
e__ J
If value of construction is 52500 or more, a KtLUKUtU wozIce 01 -4--
SUPPLEMENTAL CONSTRUCTION LIEN LAIN 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: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Address:
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.
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
K1_44.-„ r,f ('..m mcnramont
commencrn worK vi 1 Cwr uli 1r, YOU,
Signature of Own er7 fesseeyl!ontractor as Agent for Owner
Signature of Contrac o Licens older
STATE OF FLORIDA
STATE OF FLORIDA
SA Lt-t�i
COUNTY OF 5� l ei a
COUNTY OF e
The forgoing instrument was acknowledged before me
The forgoing instrum nt was acknowledged before me
�' by
this � day of Ao ri l 20� by
this day of 20 l
KeVi�V Q lUls-�v i45zr�
Kec�w R /%%4111.05
Name of person making atement
Name of per/son making std eYnent
Personally Known OR Produced Identification
Personally Known L— OR Produced Identification
Imo—
Type of Identification
Type of Identification
Produced
Produced–
roduced(Signature
otary Public- f orida)
(Signature of N t ry Public- S e of FI i
(Signature
CHRYSTALGOMEZ
Commission No.���03 (�eidl)COMMISSION#FF 20332
t {®3o�°��RY,PUB� CHRYSTALGOMEZ
(Se�lOWMMISSION#FF 20
Commission No. _#0-
EXPIRES: February 24, 201
EXPIRES: February24,2BondedBudgetNotaryServics
Thru
�o�O Bonded ThruBudget Notary Se
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17