HomeMy WebLinkAboutBuilding Permit Application WOW
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/12/21 Permit Number: �! 0
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Building Permit Application O
Planning and Development Services �®
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982 Pe��`r� �e
Phone:(772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: RV slab/ramp/driveway repair
PROPOSED IMPROVEMENT LOCATION:
Address: 903 Osceola Dr Fort Pierce FL 34982
Property Tax ID#. 3409-411-0003-030-6 Lot No.None
Site Plan Name: Block No. None
Project Name: 9 36 40 S 135.53 FT OF W 160 FT OF E 1/2 OF N 30 AC OF NE 1/4 OFSE 1/4(0.50 AC)(OR 3207-2211)
DETAILED DESCRIPTION OF WORK:
Pour concrete for RV parking area 36x20 w/12x12 footing(2)#5 rebar,install ramp for RV parking area 10x20 and driveway repair 20x20
6"thick 3000psi with fiber mesh
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: 1320 Sq. Ft. of First Floor:
Cost of Construction:$ 12,200.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Lorette Gouws Name:Jose Vides
Address:903 Osceola Dr Company:JosB Concrete Perfection
City: Fort Pierce State:_ Address:383 SW North Shore Blvd
Zip Code: 34982 Fax:None City: Port St Lucie State.FL
Phone N0.7728125066 Zip Code: 34986 Fax: None
E-Mail:None Phone N07722406170
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.
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:
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 commencing work or recordipg your Notice of Commencement.
<� zz::5� — —4 ��' —
Signature of Owner/Le /Contractor as r Owner Signature of ntractor/License H er
STATE OF FLORIDA STATE OF '
COUNTY OF COUNTY OF
_Warn to(or affirmed)and subscribed before me of Sw�to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this_IT-day of Fo4p 2021 by this L day of 2020"by
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 Identification
Produced Produced
(Signature of Vary Public-State of Florida (Signature of No#y Public-State of Florida)
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DATE
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iev.5/6/20