HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: June 10, 2020 Permit Number: oLlJ (o'er J
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Q Building 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: L.E.B. Demolition, & Consulting Contractors, Inc.
PROPOSED IMPROVEMENT LOCATION: .
Address: 663 Rio Vista Drive, Fort Pierce, Florida 34982
Property Tax ID #: 2426-501-0017-000-4
Site Plan Name: 663 Rio Vista Drive
Project Name: 663 Rio Vista Drive
(.DETAILED DESCRIPTION OF WORK:
Complete demolition of structure / Sunshine 811 Ticket 329003571
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
_, Electric 71Plumbing ' _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 3,575.06
_ Generator
Lot No.15
Block No.
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer —Septic Building Height: One
OWN ERAESSEE:_
CONTRACTOR:
Name Matthew W. Schauer
Name: Chad Gerome Taylor
Address: 715 Rio Vista Drive
Company: L.E.B. Demolition & Consulting Contractors, Inc.
City: Fort Pierce State: _
Address: 7 Harbour Isle Drive East 204
Zip Code: 34982 Fax:
City: Fort Pierce State: FL
Phone No. 772-216-1286
Zip Code: 34949 x; 772-461-2225
E-Mail:
Phone No 772-461-4545 772-216-128 ,
Fill in fee simple Title Holder on next, page ( if different
E-Mail iwreckn@aol.com �>, \3 p
from the Owner listed above)
State or County License CGC1519945
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X_ Not Applicable
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 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 attorney -before corpoencine work or recordine vour-No ce of Comm 2 cement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucie
COUNTY OF Saint Lucie
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
X Physical Presence or Online Notarization
this 10th day of Decernber 2020 by
this iotn day of December , 2020 by.
Name of person making statement.
Name of person making statement.
Personally Known X R Pr duced Identi ication
Personally Known x OR Pr duced Identification
Type o dentificatio
Ty of Identification
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(nature of Notary Public- State of Florid 5 ao��
Commission No. 000ss3os IS �'�
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