HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Date: 1/22/21 Permit Number: ° "G S l3
91ro RECEIVED
lam!
JAN 2 6 1011
Building Permit Application Permitting Department
Planning and Development Services St. Lucie county
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: p
PROPOSED IMPROVEMENT LOCATION:
Address: 8206 Bayard Rd Fort Pierce
Property Tax ID#: 1301-605-0387-000-0 Lot No. 9
Site Plan Name: Block No. 56
Project Name:
DETAILED DESCRIPTION OF WORK:
Remove and replace existing driveway and culvert-same dimensions 101 wide
4"thick 3000psi with fiber mesh
New Electrical Meter Second Electrical Meter
F
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: So O Sq. Ft. of First Floor:
Cost of Construction: $ 6500.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Robinhood Ter Name: Jose Vides
Address:3053 Rancho Vista#H373 Company: JosB Concrete Perfection
City: Palmdale, CA 93551 State:_ Address:383 SW North Shore Blvd
Zip Code: 93551 Fax: None City: Port St Lucie State:FL
Phone No. 772 267 2001 Zip Code: 34986 Fax: None
E-Mail:None - Phone N0772 812 5066
Fill in fee simple Title Holder on next page(if different E-Mail Josbconcreteperfection@hotmail.com
from the Owner listed above) State or County License 25230
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTf_ON LI.€N LAW INFORMRTIO�iV � �$ � `� �� �� -�
1
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 oft!!for/License Holder
STATE OF FL A STATE OF FLOI�IIJA
COUNTY OF • t-v�'�i COUNTY OF
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 S4^ .202* by this '%\�day of 202� by
'5oti%_ N �\�kRL5 'Soso �),\�e5
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 V-\. 0\' Produced-01-
i?"'l�a 11,6 — (��
(Signature of Not iez-Stet .:.�4 (Signatu c-State of FI ida)
ELLEN VAUC; , `=o�PRYP�e,
Commission No. _` `" ;. of Flo( �ct,;y .,, Commi ^_StateEfLEN VAUGH
; ..7 :emission # GG ^ ;� ti .c o a N�7
Commission Exp, ec ;rF F16 My Cossion # GG�Y Public
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REVIEWS - staf �Pl� `Not r ICE, SOR PLANS VEGETATI LE MANGROVE
_MV,# GG 27 REVIEW REVIEW REVIE tY REVIEW
DATE 0�tafir X.�res
RECEIVED - -_
DATE
COMPLETED
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