HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date's 11%` 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 xx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT''LOCATION
Address: 434 SE Naranja Ave
Legal Description: RIVER PARK-UNIT 4 BILK 32 LOT 13 (MAP 34/27N) (OR 3937-2927; 4097-2191)
Property Tax ID##: 3419-530-0013-000-7 Lot No.4
Site Plan Name: Block No.
Project Name:
Setbacks Front Sack: Right Side: Left Side:
DETAILED DESCRIPTION 01=WORK
1
*New construction 0 X -10 ig fi 1 -7 X g SIZ6
Pour concrete for driveway 16'wide(18'at garage entrance) 6)CID/
400hick IMoUqe-V install culvert pipe x"
CONSTRUCTION'IN FORMATION:
Additional work to be performed under this permit-check all appy:
HVAC Gas Tank ❑Gas Piping lenerator
Shutters Windows/Doors
Electric 0 Plumbing Sprinklers [ E]Roof Roof pitch
Total Sq.Ft of Construction: 0 0 S .Ft.of First Floor:
Cost of Construction:$ Utilities:llSewer Septic Building Height:
OWNERAESSt SCONTRACTOR:
Name V. I Name: Jose Vides
Address: - c -) Company: JosB Concrete Perfection
City: _ State._ Address: 383 SW North Shore Blvd
Zip Code: Fax: City: Port St Lucie State: FL
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Phone No. t 2 6 Zip Code: 34986 Fax: None
E-Mail: Phone No. 7728125066
Fill in fee simple Title Holder on next page(if different E-Mail:josbconcreteperfection@hotmailcom
from the Owner listed above) State or County License: 25230
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SIJPPL'EMEtVTAL GONSTRUCTIDNrL1EN 1.A1N INFORMATIOIU
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:Jose Vides
Address:434 SE Naranja Ave Address:
City: State: City: Port St Lucie State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:383 SW,North shore Blvd 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.
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
commencing work or recording our Notice of Commencement.
Signature of Owner/Le se /Contractor as Agent fo wrier ; Signature of C tr o
STATE OF FLORIDA& STATE OF FLORI
COUNTY OF L a COUNTY OF Z
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The f oing instru t was acknowledgesfore tlw The forgoing instr nt was acknowledge fore me Cd sLW
this �� day of 20 by o mopa this day of 20 f by o O��
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Name of perso aking statement +'.':egg.,; Name of person makingstatement = :rg
Personally Known OR Produced Identificati Personally Known_oef— OR Produced Identification ;
Type of Identification
�"`. identification
Produced Produced
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A I I/P1 J-.A 0441�x')-
(Signature of ary Public-State of Florida) (Signature of ary Public-State o Flo da)
Commission No. (Seal) Commission No. (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