HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED II''
Date: ' "" Permit Number: �f�3 •Ociq?
91r LUC E RECEIVED
0 MAR .3 ��?1
Building Permit Application
Planning and Development Services PerSt.L ue ci CftW e'k
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:
PROPOSED';I M PROVEM ENT LOCATION.
Address: 808 ANITA ST., Port St Lucie, FI. 34982
Property Tax ID#: 3403-332-0004-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED'DESCRIPTI IN OF WORK:
remove existing shingle, re-nail deck, install ICF Board for pitch, install peel-n-stick underlayment, 5-V crimp metal
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 _Plumbin (, G _Sprinklers _Generator _Roof 5 �� Pitch
Total Sq. Ft of Construction: 00 Sq. Ft. of First Floor: .
0
Cost of Construction: $ Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE; `''. CONTRACTOR:
NameVitelio J Calderon Name:Richard Newland
Address:808 Anita St Company:Richie the Roofer
City: Port St Lucie State:_ Address:
905 13th st sw
Zip Code: 34982 Fax: City: Vero Beach State:FI
Phone No. Zip Code: 32962 Fax:
E-Mail: Phone No772-473-6197
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License CCC058021 /20506
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 CONSTRt1CTIO;N LIEN LAt1V,INFORMATt�iV f '
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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: _loot 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 onand 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 inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
ttfr—e of Owner Lessee Contractor as Agent for Owner nature of Contractor License Holder
/ / g /
STATE OF FLORIDA STATE OF FL
COUNTY OF 1 -4��So1( ,l COUNTY OF - LLIW
The forgoing instrument was acknowledged before me The fo oing instrument as acknowledged before me
this day of MCl LGV1 12 al by day of 20-Z,/by
ca 1�&A C1 0-4 j)
Name of perso king statement Name of person ma ' g statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
I
(Sign a of NotaiAy Publ o-Sta f Fig Si nature of Notary Public-State
a�a�� F L O R LOPE ► Notary Publie State of F ri
PY PU/yam
Commission No. =z�'P °° �te of Florida-Notar �Bb4I sion No. J ends P Sanderao
Commission # GG 2 2142 My iresMssionGG21 2
3� Expires 04/25/2022
�� OFFIOP My Commission E Aires a
nlll,\ April 01, 2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE .
COMPLETED
Rev.8/2/17