HomeMy WebLinkAboutBuilding Permit ApplicationAll APVILICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i a ��i I Permit Number: Q
DEC 13 2019
ST. Lucie County, PerrT
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 Residential X
PERMITTYPE:Dock & Boat Lift
ROUEIVIENTjLOCATIONi i
Address: 206 OLive Avenue, Port St Lucie, FL 34952
Property Tax ID #: 3419-510-0264-000-9 Lot N0.33
Site Plan Name: River Park Block No. 19
Project Name: Burley Dock
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'pp110" F;NkINRIO#'WORK-P. �h `ri
Construct
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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: 503 Sq. Ft. of First Floor: _
Cost of Construction: $ 20,000.00 Utilities: -Sewer _Septic
_ Windows/Doors
Roof Pitch
Building Height:
I
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CONTRACTOR: 11
NameAaron Burley
Name: Dale Gasparik
Address:206 Olive Avenue
Company: LD Contracting
City: Port St Lucie State: _
Zip Code: 34952 Fax:
Phone No. (772) 247-8230
Address:2633 SW Tanforan Boulevard
City: Port St Lucie State: FL
Zip Code: 34987 Fax:
Phone No (772) 924-7244
E-Mail: aaronburley86@hotmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed, above)
E-Mail ldcontractinginc@gmail.com
State br County LicenseCBC059269
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.
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�;SIPPLE�%IENi AL�CONSTRUCTIONdLIEN
LAW'INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Pdei weic, Inc
Name:
Address: lses sw elt— street
Address:
City: PortStUde State: FL
City: State:
Zip:349M Phone(772)785.9888
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
T E FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
S ED ON THE .DOB SITE BEFORE THE FIRST INSPECTION. t YOU INTEND TO OBTAIN FINANCING, CONSULT
VlFITH*OUR LENJDEWOR AN ATTORNEY BEFORE RECORDING YOUYOUO NOTICE OF COMMENCEMENT."
Signa ree of Owner/ Lessee/Contractor as Agent for Owner
Signatur of n ractor License Holder
STATE F
COUNTYOF0.1erIA (.lP
COUNTY LACj,,l
The forgoing instrumept was acknowledged before me
The forgoing instru nt was acknowledged before me
th' M day of I ,,)i -n Wr . 204 by
this day of nyPM1,P_r . 20_5by
Na of person maki'iig statement.
NameWperson making s atment.
Personally Known ✓ OR Produced Identification
Personally Known ✓/OR Produced Identification
Type of Identification
Type of Identification
Produc
Produced
4Sigof
S' re o
;�g"'ssy: EGINA HELLBERG
NotaryP
e kg&A HELLBERG
;v°'i•
Commission N
•
MY COMMISSIOf t%11Ib071548
Commission No.
:'= MY COt4yM)ON # GG071646
_=
EXPIRES February 09. 2021
"-M. EXPIRES February 09, 2021
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