HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE CC..„.,LETED FOR APPLICATION TO BE ACCEPT cu
Date: Permit Number: I'l On ,0 �4US
•
. 919�
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 V
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION: �r c oo _c�-o.r•a CFt,,�,��y
Address: ecce
Legal Description: "K2L�c,o
--
Property Tax ID#: —ro 00 Lot No.
Site Plan Name: Block Nc, 7
Project Name: V -
Setbacks Front Back; Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
S
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit-c ec aI appy;
HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric Plumbing Sprinklers El Generator Roof Roof pitch
Total Sq. Ft of Construction: 5_0 Sq. Ft. of First Floor:
Cost of Construction: $ 131' Utilities: Sewer 0Septic Building Height: �(�
OWNER/LESSEE: CONTRACTOR:
Name C"s Name:
Address: o J y ce Company:
City: e-CC e- State:-(�L Address: Zl c7 '0's\o
Zip Code; 3`{ck S t Fax: _ City: Uero � State-.4--16—
Phone No. S6 I- 3 Sg- 2Z3p Zip Code: 321 Z Fax: I LO 2-.S-
E-Mail:
SE-Mail: Phone No. 6 K03
Fill in fee simple Title Holder on next page ( if different E-Mail:
from the Owner listed above) State or County License: _S3 �3
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 twice for
improvements to your property. A Notice of Commencement must be recorded 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 your Notice of Commencement.
s
Siat of vner/Lessee/Contractor as Agent for Owner Signature of Contractor/License der
AT OF FLORIDA STATE OF FLORIDA
C U TY OF SrN�N COUNTY OF ��
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1011 day of ao\,K 20Q by this 1! day of v 20 (7 by
(Name of person acknowledgi (Name of person acknowledging)
(Signature of Notary Public-State of Florida ) (Signature of Notary Pub State of Florida )
Personally Known OR Produced Identification t/ Personally KnownOR Produced Identification
Type of Identification Produced ,,// --c—fiD(, Type of Identification Produced
Commission No.`�"'�d����L. (Seal) CommjSAyVDFF
�U004 (Seal)
.�1rRr PUB,,
Notary Public-S
Comm.Expires
Commission#Revised 0i/15/2U1 f ;E O `• � Bonded Tittogh Nati
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE Q
COMPLETE
INITIALS
AFTER RECORDING-RETURN TO JOSEPH E.SMITH,CLERK OF THE CIRCUIT COURT
SAINT LUCIE COUNTY
FILE# 4333109 07/24/2017 08 AM
OR BOOK 4022 PAGE 2379-; Doc Type:NC
RECORDING: $10.00
PERMIT NUMBER:
NOTICE OF
The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713,
Florida statutes the following information is provided in the Notice of commencement.
1. DESCRIPTION OF PROPERTY(6615 FT.PIERCE BLVD, FT PIERCE, FL 34951) TAX FOLIO NUMBER: 1301-607-0198-
000-4
SUBDIVISION BLOCK TRACT LOT BLDG UNIT
LAKEWOOD PARK-UNIT 7- BLK 77 LOT14 (MAP 13/02N) (OR 2776-1448)
2. GENERAL DESCRIPTION OF IMPROVEMENT:
ROOF REPAIR
3. OWNER INFORMATION: a.Name: Jacques Pons & Susan V Pons
b.Address: 6615 FT.PIERCE BLVD, FT PIERCE, FL 34951
c. Interest in property: Owner
d. Name and address of fee simple titleholder(if other than owner)
4. CONTRACTOR'S NAME,ADDRESS AND PHONE NUMBER: Panda Contractors, Inc, 1210 Oslo Road, Vero Beach, FL 32962
Ph: 772 778-6803 Fax: 866 711-0251
5.SURETY'S NAME,ADDRESS AND PHONE NUMBER AND BOND AMOUNT:
6. LENDER'S NAME,ADDRESS AND PHONE NUMBER:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7.,Florida Statutes:
NAME,ADDRESS AND PHONE NUMBER:
8. In addition to himself or herself,Owner designates the following to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b),Florida Statutes:
NAME,ADDRESS AND PHONE NUMBER:
9. Expiration date of notice of commencement(the expiration date is 1 year from the date of recording unless a different date is
specified) ,20
WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I SECTION 713.13,FLORIDA STATUTES,AND CAN RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR
LENDERO AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Si n r of er or Print Name and Provide Signatory's Title/Office
Ow or's utho zed Officer/Director/Partner/Manager
State of lorida
Coun
The fo Booing instrument was acknowledged before me this day of � 20 I /
By J Xe_ �O�S as
(Name of person) (Type of authority...e.g.Owner,officer,trustee, attorney in fact)
For CAL_/Z.'_S -->or'5
(Name of party on behalf of whom instrument was executed) Pers Know r produced the following type of ID: 1L
ISAAC PEREZ
PUB i
(Printed Name of Notary Public) (Signature of Notary Public) ?r°. .`0= Notary Public-State of Florida
.•_My Comm.Expires May 18,2018
Commission # FF 086006
E°F • National Notary Assn.
Under penalties of perjury, I declare that I have read the foregoing and that the facts in it are true to th besf't5A11'i� kn
belief(section 92.525, Florida Statutes).
Signature )of Owner(s) r Owner(s)'Authorized Officer/Director/Partner/Manager who signed above:
Rev.Oe/30/2007 eaordi g)