HomeMy WebLinkAboutAPPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/30/2020 Permit Number:
r _ c Building Permit Application
Planning and Development Services
Building and Cade Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: RESIDENTIAL BUILDING PERMIT
PROPOSED IMPROVEMENT LOCATION:
Address: 4637 S HEADER CANAL RD FORT PIERCE FL 34945
Property Tax ID #: 3202-500-0007-000-3
Site Plan Name: PERSNICKETY FARMS PB 66.40
Project Name: PERSNICKETY FARMS P13 66-40
Lot No. 7
Block No.
I DETAILED DESCRIPTION OF WORK: I
CONSTRUCTION OF NEW SINGLE FAMILY RESIDENCE
New Electrical Meter X Second Electrical Meter
[CONSTRUCTION INFORMATION:
Additional work to be performed under this permit –check all that apply:
X Mechanical _ Gas Tank —Gas Piping _ Shutters X Windows/Doors _ Pond
X Electric X Plumbing Sprinklers _ Generator X Roof X Pitch
Total Sq. Ft of Construction: 4517 Sq. Ft. of First Floor: 4517
Cost of Construction: $ 275,000 Utilities: — Sewer X Septic Building Height: 23'- 3 3/16"
OWNERAESSEE:
CONTRACTOR:
Name JUAN RQUINTEROS
Name:
Address: 4652 SW WADE DR
Company:
City: PORT ST LUCIE State: FL
Zip Code: 34953 Fax:
Phone No. 772-979-4956
Address:
City: State:
Zip Code: Fax:
Phone No
E -Mail: JESSQUINTEROS@GMAIL.COM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail
State or County License
11 VdIUV V1 wn56ruc11on m 4auu or more, a Kt4VKutU Notice OT Lommencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: FRANK LIEBLER
MORTGAGE COMPANY: x Not Applicable
Name:
Address: 2254 51h Ave SE
Address:
City: VERO BEACH State: FL
Zip: 32962 Phone 772-3244500
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
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 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 at
me bef commen.cing work or recording our Notice of Commencement. J
A
wner/ Lessee/Contractor as Agent for Owner
VTATEOF
Signature of Contractor/License Halder
ORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or
Online Notarization
Physical Presence or Online Notarization
this 30 day of SEPTEMBER
2020 by
this day of , 2020 by
JUAN R QUINTEROS
Name of person making statement.
Name of person making statement.
Personally Known x
Produced Id tification
Personally Known OR Produced Identification
Type of Identificatio
Type of Identification
Produced
Produced
yr1
Sia Beim
(Signature of Notar
S
E%P & 17,2M
{Signature of Notary Public- State of Florida }
Commission No_
AM No%ry
Commission No. (Seal)
REVIEWS FRONT
ZONING SUPERVISOR
PLANS VEGETATION SEATURTLE MANGROVE
COUNTER
REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.