HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE IN 0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
11 Permit Number:`$d1 d X5-a'
NCO ° '
'Ic—, RECEIVED
Building Permit ApplicationJUL 0 9 2m
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 4803 Paleo Pines cir
Legal Description: 4803 Paleo pines Cir
Property Tax ID#: 1312-801-0125-000-2 Lot No.322
Site Plan Name: Block No.
Project Name:
Setbacks Front 18 Back: 28.5 Right Side: 80.7 Left Side: 5
DETAILED DESCRIPTION OF WORK:
new concrete driveway 80xl4ft side concrete driveway
CONSTRUCTION-INFORMATION:
Additional work toe e orme under this permit—check a appy:
[1HVAC 13 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
0 Electric Plumbing Sprinklers ElGenerator Roof
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 2100 UtilitiesInSewer 0Septic Building Height:
OWNER/LESSEE: CONTRACTOR:Cove Concrete &co
Name Terry F Benton Name: Juan Moran
Address:4803 Paleo pines cir Company: Cove Concrete&co Ilc
City: #Pierce State:Fl_ Address: 9156104th ave
Zip Code: 34951 Fax: City: Vero beach State:Fl
Phone No. Zip Code: 32967 Fax:
E-Mail: Phone No. 772 453 3434
Fill in fee simple Title Holder on next page(if different E-Mail: CoveConcrete@gmail.com
from the Owner listed above) State or County License: CRC1331029
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _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:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counter makes no representation that is granting a permit will authorize thepermit 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.
"0000,
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_Signature of Owner/L see/Agent Sign re of Cont actor/License Holder
STATE OF FLOR�DA STATE OF FLORIDA ,
COUNTY OF COUNTY OF sA---
The forgoing instrument was acknowledgedt�efore me The forgoing instrument was acknowledged before me
this'\ day ofZ %�%3 20 Eby this day of 20 k4 by
" Nl A .n a .n
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notaryublic-State of Florida) (Signature of Nota ublic-State of Florida)
Personally Known OR ProdAced Identification Personally Known OR Produced Identification
Type of Identification Produced VIAL 40'L_. Type of Identification P rpd,X-ed_
_ rsa� °"—- l�d' to;oo:••, OF-ANNA MARIE GIVENS
Commission No. „ „ %RIEGIVENS Commission No.
MYCOp"."��N#GG 022023 l
DE(&till) ti#GG 022023 _ EXPIRES: a ember 16,2020
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ber Bonded Thru Notary Public underwriters
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Revised 07/15/201 „�
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