HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Dt
L n 1
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
Commercial Residential X
PERMIT TYPE: Front door replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 6812 Wadsworth Terr, Port St Lucie, FL 34952
Property Tax ID #: 3415-705-0038-0000=2
Lot No. 37
Site Plan Name: Block No. 1
Project Name: Martin - St Lucie Housing Rehab
DETAILED DESCRIPTION OF WORK:
Front door replacement for a new impact solid fiberglass door
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
Electric _ Plumbing __ Sprinklers
Total Sq. Ft of Construction: 1,965 sqft living area
Cost of Construction: $ 650.00
Generator Roof _ Pitch
Sq. Ft. of First Floor: 3,870 sqft
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Raymond and Lerin Martin
Name: Jose De La Hoz
Company: DE LA HOZ BUILDERS, INC.
Address: 6812 Wadsworth Terr,
City: Port St Lucie , FL State:
Address: 258 Del Monte Rd
Zip Code: 34952 Fax:
City: Sebastian _— State: FL
Phone No. 772-971-8201 —__
Zip Code: 32958 Fax: 772-589-8127
E -Mail:
Phone No 772-228-9723
Fill in fee simple Title Holder on next page ( if different
E -Mail hilda@delahozbuilders.com
from the Owner listed above)
State or County License CGC1514151
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
Address: _ _
City: _ _ State:
Zip: Phone
MORTGAGE COMPANY: Not Applicable
Name:
_
Address:
City: _ State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:_
City:_
Zip: _ Phone:_
BONDING COMPANY: Not Applicable
Name:
Address_
City:
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 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 COM Cf� MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE COMMENCE NT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. YOU INTE T OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING UR ICE F C MMENCEMENT."
Rev. 211119
Signatu e of Owner%Lessee/Contractor as Agent for Owner
S ig4of Lice e H Ider
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 'Y'T t;, CZ -6
COUNTY OF
The forgoing instrument was acknowledged before me
The f2E&oing instrument was acknowledged before me
this 20 day of A -et H _by
this �, 2( c� by
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
(Signat re of Notary Publi - t FIAT De La Hoz
(Signature otary P blit- Sta (>t;A'i,�i la) TERRY A. GARDNER
My Commission GG 957948
Ex 120/2024
'��,. 'S`a�
° .�.L�"-, Notary Public - state of Flor
a: 4 GG 20047
Commission No. R �
Ammission
Commission No. � �q�bkr,m. Expires Mar 26, 2
Gb 7�OFf�C'�
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Bonded through National Notary
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 211119
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