HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ O
Date: LQ- 12 Permit Number:
Ji
Al
RECEIVr�
Building Permit Application
Planning and Development Services APR 16
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Pzrr
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residentia
PERMIT APPLICATION FOR: Roalavation
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.7
Site Plan Name: Block No. 128
Project Name: Hill- Hurricane Loss Mitigation Repairs
Setbacks Front _ Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace garage door
CONSTRUCTION INFORMATION:
Additional work to be oertormed under this permit—check all that appy:
HVAC 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: $ $1,500.00 Utilities:cnSewer F1 Septic Building Height:
OWNER/LESSEE: 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 09:32 AM DE LA HOZ BUILDERS INC. 7725898127
PAGE. 1/ 3
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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 1111 authorize the permit holder to build the subject str cture
which Is in conflict with any applicable Home Owners Association ru es,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 r In your paying twice for
Improvements to your�Ifyo
Notice of Commencement must be re ed an osted on the jobsite
before the first inspe( tend to obtain financing,consult wi lender or attorney before
commencin work o rr Notice of Commencement,
Signature of Owner a aa/L act r as gent for Owner Signature of Contrac or a se H Ide
STATE OF FLORIDA STATE OF FLORIDA q
COUNTY OF _ 14 P_ ALV& COUNTY OF�^ /h��F�IQ�VIA^
The forgoing Instrument was acknowledged before me The forgoing Instrument was acknowledged before me
this L?_day of � 20* by this,a day ofVY) 1 20.!1- by
Name of person king statement Name of person king statement
Personally Known OR Produced identification Personally Known R Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signatur Ota Ilc-State of Flori Kew Jww Sig tur otary - of Florida)
NOTARY PUB C Kwin Janes
Commission No. STATE OFF mission No. NOTARY
ComnW FF247 I STATE OF Fl
r T gcomo FF247 i
1
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE
COMPLETED
Rev.8/2/17
PEA-1�1LI SL-C 404 - 01 Y1