HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: ,, �� Permit Number:
RECEIVED l
Building Permit Application APR 16 2018
Planning and Development Services ST. Lucie county, Permitting
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: Renyvatim
� mpr
PROPOSED IMPROVEMENT LOCATION:
Address: 6902 Bayard Rd, Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 10- BLK 128 LOT 7 (MAP 13/01 S) (OR 3216-2833)
Property Tax ID#: 1301-612-0213-000-2 _ Lot No.?
Site Plan Name: Block No. 128
Project Name: Hill- Hurricane Loss Mitigation Repairs
Setbacks Front _ Back: Right Side:_ Left Side:
DETAILED DESCRIPTION OF WORK: 71
Replace one exterior door 6 i-z r-e F-oc " Ke)
[CONSTRUCTION INFORMATION:
Additional work toe er orme under this permit—check a appy:
HVAC 11 Gas Tank Gas Piping _Shutters ✓�Windows/Doors
Electric ❑ Plumbing Sprinklers ❑Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ $990.00 Utilities:n Sewer 0 Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Dontavius&Tunisha Hill Name: Jose De La Hoz
Address:6902 Bayard Rd _ 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.772-475-1426 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.
Apr. 18.2018 09:33 AM DE LA HOZ BUILDERS INC. 7725898127 PAGE. 3/ 3
DESIGNER ENGINEER: x Not Applicable MORTGAGE COMPANY: _Not Applicable
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%l aut orize the permit holder to build the subject sttri�cture
which Is In conflict with any applicable Home Owners Association rules,by aws or and covenants that may restrict or prohlblt 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 ail 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 OWN • r failure to Record a Notice of Commencement ma r It In your paying twice for
improvements to -Ur
prop ty, A Notice of Commencement must be r rded a osted on the Jobsite
before the first specti I u intend to obtain financing, consult w' lender r a ttorney before
commencing
or re i o r Notice of Commencement.
Signature ow essee/ tr fora Agent for Owner Signature o r Ide
STATE OF FLORIDA /J STATE OF FLORIDA
COUNTY OF //1 C�CA*0 A IJ46 ' COUNTY OF �p� r v. AUCA
The forgoing Instrum9pt was acknowledged before me The forgoing Instrumjiint was acknowledged before me
this,�4 day of apj� 204 by this day of 20ZL by
Name of perso aking statement Name of pers making statement
Personally Known OR Produced identification Personally Known OR produced Identification
Type'of Identification Type of Identification
Produced Produced
nat of ate of Florida {Sign tur to tate of Florida j
Commission No, NOTARY Pug C KMA�JWr4*
STATE OF FL mission No. NOTAR
comffO FFZ4 11 STATE A
7/6/2 19REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGRO
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17