HomeMy WebLinkAboutbuilding permit"PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date4 / 3 L 2.0_ _ _ % Permit Number:
'J i A=
LWU*14
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resident ra�xx
PERMIT TYPE: Concrete Driveway Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 5710 Papaya Dr Fort Pierce 34982
Property Tax ID #: Parcel ID: 3402-610-0273-000-0 Lot No. 8/9
Site Plan Name: Block No. 79
Project Name:
DETAILED DESCRIPTION OF WORK:
Pour concrete for driveway 19x50 - Remove and replace existing concrete driveway (garage to road) 4" thick
3000psi with fiber mesh
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $
7500
Sq. Ft. of First Floor: _
Utilities: —Sewer _Septic
Windows/Doors
_ Roof Pitch
Building; Height:
OWNER/LESSEE:
CONTRACTOR:
Name Liberatore, Dominic L
Name: Jose Vides
Address:5710 Papaya Dr
Company:JosB Concrete Perfection
City: Fort Pierce State: _
Zip Code: 34982 Fax: NSA
Phone No.7728125066
Address:383 SW North Shore Blv
City: Port St Lucie State: FL
Zip Code: 34986 Fax: None
Phone No7722406170
E-Mail: N/A
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail josbconcreteperfection@hctmail.com
State or County License25230
— -- - wnou ut.uvn t] -7L7VU Uf MUfe, d RC%-Uf%UCU rvOilce oT LOmmencement Is requlrea.
If value of HVAC is $7,500 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:
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 FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NQTICE OF COMMENCEMENT."
Signature of Owner/ es or as Agent for Owner
Signature of Co"a for/License Holder
STATE OF FLORIDA -
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgo'ng instrument was acknowledged before me
The forgoi g instrum t was acknowledged before me
thi�day of _� i / 2Q�i�7by
this ay of z 1Q1(% by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Xr�
Type of Identification
Produced
Produced
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(Signature
(Signature ci o
a'' =� CATHERINE A WEINMAN
B�'•,-
in; Notary Public pf Plorida
Commission No. ry 233 910d
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;^S�iY FUE.�., CATHERiNE A `VEI�iMA�•1
Commission a' Notary Pcbk - State of
mission
My Comm. Expires Aug 23, 2022
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DATE
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Rev.2/7/19
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TYPE OF SURVEY: BOUNDARY PLOT PLAN U C TIE IN FINAL TOPOGIiAPHI E
COMPLETEDON: 1-05-16
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