HomeMy WebLinkAboutPermit application for 5686 Travelers way_000354All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/11/2021 Permit Numb( r:
�t. LUCE R
0
`3 t� Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential XX
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: driveway repair
PROPOSED IMPROVEMENT LOCATION:
Address: 5686 Travelers Way Fort Pierce 34982
Property Tax ID #: 3410-503-0057-000-6 Lot No. 12
Site Plan Name: Block No. B
Project Name:
DETAILED DESCRIPTION OF WORK:
Remove and replace damaged concrete at entrance to driveway approximately 10x2 5 (no termite treatment required)
4" thick 3000psi with fiber mesh
PRIVATE COMMUNITY - NO CULVERT - NO ROAD AND BRIDGE INSPECTION NEEDED
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 _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 250 Sq. Ft. of First Floor: _
Cost of Construction: $ 5000 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ruth Wilkins
Name: Jose Vides
Address: 5686 Travelers Way
Company:JosB Concrete Perfection
City: Fort Pierce State: _
Zip Code: 34982 Fax: None
Phone No. 772 240 6170
Address:383 SW Norte Shore Blvd
City: Port St Lucie State: FL
Zip Code: 34986 Fax: None
Phone N0772 8125066
E-Mail:None
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailjosbconcretepe lection@hotmail.com
State or County Licen:.e 25230
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: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPAP;lY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:: _Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to dr.) 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 Folder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and coven: nts 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 Amerdments.
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 inspectigQ.Q. If you intend to obtain financing, consult
with lender or an attornev before commencing work or recordikil voor Nctice of Commencement.
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Signature of C nt c4er%1'.
o er
Signature of Owner/ s e/ r as Agent for Owner
STATE OF FLORIDA
STATE C FLO A
COUNTY OF
COUNTY OF
SWc rn to (or affirmed) and subscribed before me of
!C
Sworn to (or affirmed) and
subscribed before me of
Physical Presence or Online Notarization
V P,hy�ical Presence or
Online Notarization
this/ delay of 2020 by
this/day of =
_ml 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification _k"
Personally Known ._
OR Produced Identification )el
Type Type of Identificatio
Type of Identificati n
Produced
Produced
(Signatuiief No Pu ic- tate of Florida)
, (Signature o otary Pi iblic- State I
Commission No. (�al� 5; r_, da
"
'.Commission No. �
CATHERIN A VENVA.
P Seal) r �� ` t' `
T Commission - GG 2391
C_-rrm;ss:'r GG 239134
g 23. 2C22
c:
mi comm.. x ires Aug 23
worded thr
^ ";a r Nota y s
-'
REVIEWS
FRONT
PLANS
VEGETATION
SEK TURTLE
MANGROVE
50 R
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20
AlIP .