HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/29/2021
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Co m m e rc i a l
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: 3191 Daniels St Fort Pierce, FL 34981
Property Tax ID #: 3403-502-0187-000-1
Site Plan Name:
Project Name: Rivas
Replace 1 window size -for -size with impact
New Electrical Meter
Second Electrical Meter
Residential X
Lot No.
Block No.
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:
Cost of Construction: $ 3237
Name Rebecca Rivas
Address: 3191 Daniels St
City: Fort Pierce
Zip Code: 34981
Phone No. 772-577-0307
Fax:
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Name: Roberto Sanchez
Company: The Home Depot
Building Height:
State:�l- � Address: 2455 Paces Ferry Rd
E-Mail; rj723@bellsouth.net
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
City: Atlanta
Zip Code: 33039
Phone No 754-224-2010
Fax:
State: GA
E-Mail robertosanchezthd@expeditepermit.com
State or County License CGC1522717
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.
SUPPL 1 E "AL I TI UCTION'L EIS LA1/V iNFl ON
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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: 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
for
structure. Please consult with your Home Owners Association and review your deed 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 recording our Notice of Commencement.
Signature of Contractor/License Holder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Z,rle
COUNTY OF IgA000e
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
+F Physical Presence or Online Notarization
® Physical Presence or. Online Notarization
thiswP'l day of 202Q' by
this 3j day of , 2029 by
Name of person making statement.
g y Aaron Hallich
Name of person making statemeniYq aron
-PUBLIC
NOTARY
Personally Known / OR Igii ftI FLORIDA
Personally Known f�c�
Type of Identification y COMM#
Type of Identification ...• , ATE ®F �LORI A�—
Produced r,�1� ires 1/27/2024
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Produced Oom OG951577
Expires 1/27/2024
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(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. dl (Seal)
Commission No. irzx y (Seal)
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Rev.5/6/70