HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: ` P 5 Permit Number': NOS- . on35
Building Permit Application MAY 0 12011
Planning and Development Services �j r\�t eA C_- �� `
Building and Code Regulation Division `\,` 4 "��uz )c ,( PERR4117;,�G
2300 Virginia Avenue,Fort Pierce FL 34982 C5�" h�(�(�( r St• Lucie Ccuni
Phone: (772)462-1553 Fax: (772)462-1578 Co ercial RQsAential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 5
PROPOSED IMPROVEMENT LOCATION:
Address: 4735 Selvitz Rd. /-e7QCE _5 0 `6..
Legal Description:
Property Tax ID#: 3406-501-0004-000-1 Lot No.
Site Plan Name: Block No.
Project Name: Gracia Tupil Custom
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Setbacks Front;kc1 Back: 6j4•'J!SRight Side: 1 ii Left Side: ID
-DETAILED DESCRIPTION OF WORK:
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ConTRUCTION.INFORMATION:
Additionalworkto e e orme under this permit—check all t t apply:
✓ZHVAC 0 Gas Tank Gas Piping Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers E]Generator Z Roof Roof pitch
Total Sq. Ft of Construction: �a�2 S . Ft.of First Floor:
Cost of Construction: $ Utilities: Sewer Septic Building Height:
OWNERAESSEE " CONTRACTOR:
Name Demetrio Garcia Name: Julio Batista
Address:697 NW Archer Ave Company: JC and Sons Home Builders Inc.
City: Port St. Lucie State:FL Address: PO Box 7247
Zip Code: 34983 Fax- City: Port St Lucie State:FL
Phone No. Zip Code: 34985 Fax:
E-Mail:dgainc1 @gmail.com Phone No. 772-291-3591 (Carmen)
Fill in fee simple Title Holder on next page(if different E-Mail: carmendc@yahoo.com
from the Owner listed above) State or County License: Florida
If value of construction is$2500 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: Paulwelch Name:
Address:1984 SW Blltmore St Address:
City: Port St Lucie State: FL City: State:
Zip: 34984 Phone: 772-785-9888 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first ' spection. If you intend to obtain financing, consult with lender or an attorney before
commencingrk or recording our Noti mencement.
Signature Owne Lessee ractor as ge or Owner Sign re of Co actor/ ' e Holder
STATE OF FLORIDA _ STATE OF FLORIDA -
COUNTY OFF COUNTY OF
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The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 Eby this day of M,4r 20 by
(Name of erson acknowledging) (Nam of person acknowledging)
(Signature of Notary Publi tate of Florida) (Signature of Notary Public- to of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Id ntification Produced Type of Identification Produced
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Commission No. (Seal) Commission No. (Seal)
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Revised 07/15/2014 u MY Comm.Expires Dec 20,2018 ;-A ��,�, Notary Public
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