HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE Ili MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �L\ Permit Number:
s -ter— J
RECEIVED
Building Permit Applicati n
Planning and Development Services AUG 24 2098
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line �—
q s o-
PROPOSED I 1'PROVEM.E'NT.LOCATION:",
Address: 5209 SUNSET BLVD, FORT PIERCE 34982
Legal Description: INDIAN RIVER STATES UNIT 07
Property Tax ID#: 3402-608-0475-000-9 Lot No.35
Site Plan Name: Block No. 52
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF 1NORK. '
REPLACE OVERHEAD GARAGE DOOR
CQ.NSTR.UCTIO'N INFORMATION
Additional work toe e orme un er t is permit—check a appy:
HVAC f]Gas Tank Das Piping _Shutters1-1 Q Windows/Doors
Electric 0 Plumbing F ]Sprinklers Generator g Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$. Utilities: Sewer Septic Building Height:
OWNER/LESSEE . '.CO:NTRACTOR:
NameALICIA ANN GERMOND Name: FERNANDO VELASCO
Address:5209 SUNSET BLVD Company: ADVANCE BUILDING CONTRACTORS INC
City: FORT PIERCE State:FL Address: 2440 S JENKINS RD
Zip Code: 34982 Fax: City: FORT PIERCE State:FL
Phone No.203-560-5553 Zip Code: 34947 Fax:
E-Mail: Phone No. 772-342-6928
Fill in fee simple Title Holder on next page(if different E-Mail: advancebuildingcontractors@gmail.com
from the Owner listed above) State or County License: CRC 1331595
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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Sf PPLEMEiVS AL CONSxfRt�c I r Lia N LAW iN ORMATIO f } 3
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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:
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:Yo failur o Record a Notice of Commencement may result in yo paym ice for
improvements to your pr rty.A tice of Commencement must be recorded and p st d on theJobsite
before the first inspectio . I yo inte d to obtain financing, consult with lender or an ttrn y befdre
commen ' work r rec rd n our otice of Commencement.
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Signature of Owner/Lessee Con ctor as Agent for Owner Signature Contract icen der
STATE OF FLORIDA. L STATE OF FLORIDA
COUNTY OF COUNTY OF S* �-\-> '%
The forgoing instrument was acknowled eyl before me The for oing instrument was acknowledge before me
this a9 day of Qy� 20� by this�day of �� .20\1 by
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Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of identification
Produced Produced
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(Signature of Notary Pu lic-State of FI �p(i1E ofl23 (Signature of Nota DEi\NNA #GG
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REVIEWS FR ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17