HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2.2.-5z Permit Number:
'M ' !✓FINED
9 19 u Building Permit Application
JUN 2 2 2020
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division Commercial Residential XXXXXXXXX
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 5811 Birch Drive
Property Tax I D #: 3402-609-0395-000-7
Site Plan Name:
Project Name: Verastegui Res.
DETAILED DESCRIP.TIONM1OF WORK -
Change electric service from 100 amps to 200 amp service over heard service
New Electrical Meter yes 1 only Second Electrical Meter
CONSTRUCTION,INFORM' ATION:
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: 1700 sq ft Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors _ Pond
_ Roof IPitch
Cost of Construction: $ 2000.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:' ' ,
CONTRACTOR
NameAndresVeratesgui
Name:Robert T,Payuk
Address:5811 Birch Drive
Corn anY�' 'Payuk Electrid LLC
p
City: Fort Pierce State: _
Zip Code: 34982 Fax:
Phone No.772 882 0375
Address:2501. SE Calusa Ave
City: Port Saint Lucie State: FI
Zip Code: 34952 Fax: &72 335-1639
Phone N0772-337-4197
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailbobtoml'2@bellsouth.net
State or County License EC 13001275
vume ui cunssrucoan is couu or more, a KLLURDED NOtice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFQRMATION'
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
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Zip: Phone:
_Not Applicable
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 paying twice for
improvements your property. A Notice of Commencement must be recorded in the public records of St.
Lucie Courlty�osted on the jobsite before the first inspection. If you intend to obtain financing, consult
with Ienedeer o ttornev before commencine work or recording vour Notice of Commencement.
tlox
Signs I of wner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ra,r, C
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or _ Online Notarization
Physical Presence or _ Online Notarization
this flay of 75y vve. . 2020 by
this_ day of 2020 by
P.0'oee-, �+w6)c
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 t- D t--
Produced
J
(Signature of Notai is ,4�ate fIbygGG 02Ypp3
(Signature of Notary Public- State of Florida )
e o, EXPIRES: m*18,2020
•'6„t•••" e
a Commission No. ed Th' K5ftF)+MkUnd,mundewdten;
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/tU
/ �L`/(/,*)! O r (-1 r-T tzIn
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
T
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 ¢ertify'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 an� applicable Home Owners Association rules, bylaws or ancovenants that may restrict or prohibit such
structure. Please consult w th your Home Owners Association and review your deed TTor 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 failu to Record a Notice of Commencement may result in paying twice for
improve nts to your p.ro rty. A Notice of Commencement must -be recorded in the public records of St.
Lucie C my and poste the jobsite before the first tnspectio you intend to tain financing, consult
with I de •or an attor before commencing work or recordi o r Notice o mencement.
e�c4f
ignat 0 n L e/Contractor as Agent for Owner
atur ntr tor/ ' ense older
STAT OFF RI A
: STATE F F' LORIDA
COUNTY'OF
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
_ Physical Presence or Online Notarization
thi day of 2020 by
this _ day oaff 2020 by
Name of person making statement.
Name ofperron making statement(
Personally Known . OR Produced Identification
Personally Known OR Produced Identification
Type of Identifi ' n
Type of Identificgion
Produced
Produced
(SigrAafure of N tarylic-State of Florida)
(Sign
a
o::k:8%,, KAREN S. NIELSEN
.State of Florida-Notery Puppi�
Comm i o �. KA E NIEL6Pl)
Corn
State of Florida -Notary Public
•?
_• •`�3mmtsston # GG 207484�
?• Commission # GG 207484
%�+, `�d8 My Commission Expires
plf om
Jun
fission Expires
REVIE
PERVISOR
PLAN
A ON
SEATURTLE
MANGROVE
REVIE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.