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HomeMy WebLinkAboutBuilding Permit ApplicationiT 411 APPLICABLE INFO MUST BE COknri.ETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number. S51r. ILUJ QM---� %\ \JU Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential x 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CAV PERMIT APPLICATION FOR: NEW RESIDENCE PROPOSEDxIIUIPR0.1%EMENT LQCATION7 ����� ' � " �y �� m x iddress: 6003 CARLTON ROAD, PORT ST LUCIE, FL 34987 Plroperty Tax ID #: 3209-700-0004-000-7 Lot No. Site Plan Name: MONTOYA 2 ESTATES (PB 41-15) LOT 4 (8.686 AC) Block No. Pi oject Name: DETAILED DCRIPTION��OF WRi�` �dd AAfl RESIDENTIAL HOME v b 1 o .m (v 1� o►ems 2 C✓P, r 'a X New Electrical Meter cond Electrical Meter ditional work to be performed under this permit— check all that apply: X Mechanical _ Gas Tank —.Gas Piping _ Shutters 'k Windows/Doors _ Pond )C- Electric Plumbing _ Sprinklers _ Generator X Roof 5/12 Pitch Total Sq. Ft of Construction: i ©o Sq. Ft. of First Floor: Cost of Construction: $ �58-,900 '1 2-©i 000 Utilities: —Sewer _Septic Building Height: 10' DOWNER%LESSE, CONTRACTOR' a� . Name Jose Alejandro Fuentes and Mabel Gonzalez Name: owner builder Company: Address: 1651 West 37 Street #406 City: Hialeah State: FL Address: Zip Code: 33012 Fax: 305-362-9312 City: State: Phone No. 786-525-4472 Zip Code: Fax: E-Mail: mabel.premium@yahoo.com Phone No E-Mail Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License iT value oT construction is Zsuu or more, a RECORDED Notice of Commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SURPLEIUIENTAL._CONSTRUCTION LIEN! LAW`N�INF0RM J,'I F „Y .fir?. „'d 2m'«1$. W .y_,$ Yf, �F"< % i"�9• .. ,n ✓. a e. ... '..£: _ .,d. {"i v'^ �ii ,,i+°u .�f ., �'�i 3 .1. �.. `��' J . '> .;. to ..._._ - w a e DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: X Not Applicable Name: JUAN BOSCO ORDONEZ Name: Address: 15554 SW 113 ST Address: City: MIAMI State: FL City: State: Zip: 33196 Phone 305-401-2051 Zip: Phone: FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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 stru t res, s i ming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING O OW E : Your failure to Record a Notice of Commencement may result in paying twice for impr m nts t our property. A Notice of Commencement must be recorded in the public records of St. Luc[ lu p sted on the jobsite before the first inspectiori. If you intend to obtain financing, consult with Ie ie rney before commencing, work or recording our Notice of Commencement. i nature bf O . ner/ Less a/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FL RIDA5+( STATE OF FLORIDA COUNTY OF 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 —a day of AA wf J 202by this 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 �C, Type of Identification Produced iO Produced (Signature of Notary u lic- State of Florida) (Signature of Notary Public- State of Florida ) Commi o. (Seal) Commission No. (Seal) ELLE REVI -� P e of Florid . Co� , `` F�'e�� smis -Notary Public i N 679 SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE �DU WS REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/6/20