HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Date: 1/25/21 Permit Number: °lN
ti RECEIVED
Building Permit Application
Planning and Development Services JAN 2 6 2021
Building and Code Regulation Division Commercial ReSldefklWtIX*Department
county
2300 Virginia Avenue,Fort Pierce FL 34982 St. ade
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: Driveway repair
PROPOSED IMPROVEMENT LOCATION:
Address: 6009 Tangelo Dr Fort Pierce 34982
Property Tax ID#: 3402-610-0380-000-3 Lot No. 28
Site Plan Name: Block No. Unit 9
Project Name:
DETAILED DESCRIPTION OF WORK:
Repair 2 sections of concrete center of driveway 4"thick 3000psi with fiber mesh
23xl0 and 17x18
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: 536 Sq. Ft. of First Floor:
Cost of Construction: $ 5000.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Kenneth Revels Name:Jose Vides
Address:6009 Tangelo Dr Company:JosB Concretre Perfection
City: Fort Pierce State:_ Address:383 SW North Shore Blvd
Zip Code: 34982 Fax: None City: Port St Lucie State:FL
Phone No.7728125066 Zip Code: 34986 Fax: None
E-Mail:None Phone N07722406710
Fill in fee simple Title Holder on next page(if different E-Mailiosbconcreteperfection@hotmail.com
from the Owner listed above) State or County License25230
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.
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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 TITLEHOLDER: _Not Applicable BONDING COMPANY: 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 le r an attorney before commencing work or recording our Notice of Commencement.
Signature of Ow er essee/Contractor as Agent for Owner Signature of on for/License Holder
STATE OF FL A STATE OF FLOINCIA
COUNTY OF - L'o c-Nt COUNTY OF • t-\16 -k
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
this Q.Ca day of Sg 20216 by this day of �q� .202k by
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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 Identific tion
Produced Produced \�01—
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RECEIVED '
DATE
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Image capture:Mar 2015 @ 2021 Google
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Bartow St
RECEIVED
TIT: JAN 2 6 2021
Permitting Department
St. Lucie County
Easy St
FILE CO
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