HomeMy WebLinkAboutPermit and Fill AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772)462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
4511-811-0020-000-7/ WINDMILL VILLAGE BY THE SEA, UNIT TWO LOT 19/ 94 AQUA RA DR
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
GABINO INFANTE
Property Owner Name (Please Print)
Prop Owner Signature
7/7/2020
Date
STATE OF FLORIDA, COUNTY OF . I &
ACKNOWLEDGED BEFORE ME THIS 77� DAY OF
WHO IS PERS(. ALLY KNO TO MS ( ) R WHO HAS
PRODUCED - AS IDENTIFICATION.
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 07/07/2020 Permit Number:
V L O L;� Ir 0) Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:Concrete patio deck
PROPOSED IMPROVEMENT LOCATION:
Address: 94 AQUA RA DRIVE, JENSEN BEACH, FL 34958
Property Tax I D #: 4511-811-0020-000-7 Lot No.19
Site Plan Name: GABINO RESIDENCY Block No. 2101
Project Name: PATIO DECK
DETAILED DESCRIPTION OF WORK:
POOR A 4" CONCRETE SLAB ON THE PATIO AREA OF THE HOUSE 26 ' X 14.9'
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 375.5 Sq. Ft. of First Floor:
Cost of Construction: $ 1,500.00 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Gabino Infante
Name: lanquer Acevedo
_
Address: 5096 Bright Galaxy Ln
Company: Firm Builder LLC
City: Greenacres State: FL
Address:2054 Vista Pk way
Zip Code: 33463 Fax:
City: West Palm Beach State: FL
Phone No. 561-301-3875
Zip Code: 33411 Fax:
E-Mail: perezterri@bellsouth.net
Phone N0561-480-0288
Fill in fee simple Title Holder on next page ( if different
E-Mail iacevedo@firmbuilderconstruction.com
State or County License FLORI DA
from the Owner listed above)
If
is required.
value of construction is 2500 or more, a RECORDED Notice of Commencement
If
value of HAVC is $7,500 or more, a RECORDED Notice of Commencement
is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name:_
Address:
City:
Zip:
Phon
State:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:_
Address:
City:
Zip:
Phone:
Name:_
Address:
City:
Zip:
Phone:
State:
BONDING COMPANY: X 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 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 to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencing work or recording vouN Notice of Commencement.
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Signat of Owner/ Lessee/ o'n'tract r as Agent for Owner
STATE OF FLORIDA
COUNTY OF'i
Swor o (orJPre
and subscribed before me of
Ph�r� cce or , Online Notarization
this ��2020 by
Name of person making statement.
Personally Known _�� OR Produced Identificati
Type of Identification
Produced
(Signalpre°bf Notary Public- State of FI
Commission No.& .
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
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DATE
COMPLETED
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Signature of
Holder
STATE OF FLORIDA /� -
COUNTY OF,
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Sworn to (or affirmed) and subscribed before me of
Ph y ��' I Presen or Online Notarization
this _ ay of 2020 by
Name of erson making statement.
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Personally Known OR Produced IdentiR10 COS,
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