HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: October 2019 Permit Number: `C:I\\O-d S y y
RECEIVED
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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 xx
PERMIT TYPE: Driveway
PROPOSED IMPROVEMENT'LOCATION:
Address: 7379 Reserve Creek Dr Port St Lucie 34986
Property Tax ID#: 3322-601-0032-000-6 Lot No.12
Site Plan Name: 5
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Project Name:
FPETAIL(PD''ES'C"RIPTIONOFWO'RK'
Remove and replace existing concrete driveway 4"thick 3000psi with fiber mesh
COI`4STRUCTION INFORMATION
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ \-4,,a o O O a Utilities: —Sewer —Septic Building Height:
OWNER/LESS_EE -, '`GC,1: ITRACTOR.
Name Douglas and Dawn Gilbert Name:Jose Vides
Address:7379 Reserve Creek Dr Company:JosB Concrete Perfection
City: PSL State:_ Address:383 SW North Shore Blvd
Zip Code: 34986 Fax:None City. PSL State:FL
Phone No.7722406170 Zip Code: 34986 Fax: None
E-Mail:None Phone No7728125066
Fill in fee simple Title Holder on next page(if different E-Maiijosbconcreteperfection@hotmail.com
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.
I f value of HVAC is$7;500 or more,a RECORDED Notice of Commencement is required.
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-- - DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable. J�l
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.
-1 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 OWNEW. YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LWER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ or as
Le e Gritrict -Agdnt for owner Signature of Qoct&r/Lic e n s L51Holder
STATE OF FLORI()A STATE OF FL RIDk.
COUNTY OF !S'T. - VR, COUNTY OF
The forgoing instrument was acknowledged before me The for ping instrument was acknowledged before me
this'd-b day of Ge—k 20—M by this,.')- day of 6C-73V 20�1 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification of Identification
Produced C L Produced
(Signature of Notary P(bblic-State of Florida) &A
gnure of Notary P P of Fli:99M
,C)ty#GG ,Z62my COM Jr tuber 16, 2'.
Commission No.Gr.Q eal) !on No.
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REVIEWS FRONT Z f ;UPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER R REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/1119