HomeMy WebLinkAboutPOOL DRIVEWAY PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building pp Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:Concrete Driveway & Pool Deck Extension
Address: 12174 Riverbend Trc. Port Saint Lucie FL 34984
Property Tax ID #: 4422-502-007-000-8 Lot No.3
Site Plan Name: Bay St. Lucie lot #3 Block No.
Project Name: 12174 Riverbend
Demo, Replace and Extend Concrete Driveway and Concrete Pool Deck
Replace and Repair Pool Electrical and Plumbing as needed.
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit– check all that apply:
Mechanical
Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction. $ 2,000.00
Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Sprinklers _ Generator _ Roof Pitch
Sq. Ft. of First Floor:
NameFountain Plaza Investments
Address: 737 SW Port Saint Lucie BLVD.
City: Port Saint Lucie State:
Zip Code: 34953 Fax:
Phone No. 772-873-0545
E -Mail: noel@qualitytsi.com
Utilities: —Sewer —Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Gary Martinez
Company: Quality Construction Concepts LLC
Address:4385 Sw Shadd Street
City: Port Saint Lucie State: FL
Zip Code: 34953 Fax:
Phone N0561-629-6421
E -Mail garygcc@gmail.com
State or County License CRC1 332581
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
FRS. CQNSTRUCTIO ISN ��11, NRS
DESIGNER/ENGINEER: x Not Applicable
a
,
�.
MORTGAGE COMPANY: x_ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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 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.
Inconsideration 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 attorney before commencing work or recording our Notice (*Colnmencement. >.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sign ture tractor/Li nse Holde
STATE OF FLORIDA
STATE O ZORIDA
COUNTY OF
COUNTY OF •s , +A c ► e
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
Physical
this _ day of 2020 by
_'�
this � ofAJAI u 2020 by
CA0_HtMArliNez
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
Pr uce
OSMFl VAI M:(Signature
(Signature of Notary Pu I ° t` 9{ ilf4i19gl�blic-State of Florida
- *- Commission # GG 356648
Commission No. 6(7 3 �� ���`° My ��& asiZb pire
of Notary Public- State of Florida)
Commission No. (Seal)
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