HomeMy WebLinkAboutBuilding Permit Application I I
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ( p�
OctDate: ' Permit Number: 6 O
@! AP
o P.
Building Permit Application stCr;, joy
Planning and Development Services eQ09 01p ,
a
Building and Code Regulation Division CO �7��P
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: W LN-TK
PROPQD VOEMCATIQN`
Address: x p
12174 Riverbend Trace, Port Saint Lucie. FL 34984
Property Tax ID#: 4422-502-0007-000-8 Lot No.3
Site Plan Name: Riverbend Trce Block No.
Project Name: Bay St. Lucie L oT ,3
DETAILED DESCRIPTION Of=1NORK =g
New Siding Stucco Finish
t
CONSTRUCTI{ �t INFORMATION
F
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: $ 10000 Utilities: —Sewer —Septic Building Height:
I
QNNER/LESSEE `N � CONTFtACTQR
_. . ,. .
w, ;
F.
Name Fountain Plaza Investments LLC Name:Gary Martinez
Address:737 SW Port Saint Lucie Blvd. Ste.A Company:Quality Construction Concepts LLC
City: Port Saint Lucie State:_ Address:4385 SW Shadd Street
Zip Code: 34953 Fax: City: Port Saint Lucie State:FL
Phone No.772-873-0545 Zip Code: 34953 Fax:
E-Mail:noel@.qualitytsi.com; Phone No 561-629-6421 j
Fill in fee simple Title Holder on next page(if different E-Mail qualityconstructionconceptsllc@gmail.com
from the Owner listed above) State or County License CRC1 332581
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
I
I
i
i
I
Sl1PPLEMENTAL C NSTRUC", Cf IEN LAW IN {JRMATIDN
DESIGNER/ENGINEER.. Not Ap
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: 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN F NANCING, CONSULT
WITH YOUR LENDER OR ANA4TTORIOY BEFORE RECORDING YOUR NOT1QE OF COM NCE NT."
Sin re of Ow Lessee/C tractoras Ag Ower Sign ure ofC ctor/L a se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF C_�,�7
The forgg,oing instrument ryas acknowledged before me The forgoing instrument was acknowledge before me
this �L-�ay of 204 by this .1Ctiay of GP n 2ryV by
Ix\A r/4`l--a-A
Name of Pers ma king statement. Name of persoolmaking statement.
Personally Known . OR Produced Identification Personally Known OR Produced Identification
Type of IdentificatioA Type of Identificatior},
Produced Produced f`[1
p �
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida )
Commission N ELLEN V
�96 )-IN Commission
ate o Florida-Notary Public "RrP; ELLEN VAUGHN
Commission # GG 270079 :°�P agi-State of Florida-
��Fosc�� pi res =• ., commission # GG 27 079
REVIEWS ISOR PLANS �C3 J�N'M nTi xpir"A GROVE
COUNTER I REVIEW REVIEW REVIEW 22 (IEW
DATE
RECEIVED
DATE
COMPLETED
ev.2/7/19