HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : _ 05 Permit Number:
afl LUC ir
Building Permit Applicat ion
Planning and Development Services
Building and Code Regulation Division Commercial Reside flaw, X
2300 Virginia A venue, Fort Pierce FL 34982
Phone : ( 772) 462- 1553 Fax -, ( 772) 462- 1578
PERMITAPPLICATION FOR : G1�2,
*v0p,
PROPOSED IMPROVEMENT LOCATION :
Address : FO�
Property Tax ID #: / 301 - �P05 el� - Lot N o.
Site Plan Name : Block No.
Project Name :
7
DETA �UUE_ D DESCRIPTION OF WORK :
ne
nu�
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 _ Plubinr�, g _ Sprinklers _ Generator i� Roof Pitch
Total Sq . Ft of Construction : o�0f Sq . Ft. of Fist Floor:
Cost of Construction : $ oi5 Utilities : _ Sewer _ Septic Building Height:
OWNER/LESSEE : CONTRACTOR :
N a me_. �//jG{a & e/ c)a es Name : Luis Qu inon es
Address :-.. .. ��jZ�J� /�py��6�7, �' Company: Rhino Roofs & General Construction Corp
City: ), q,--ort Pleieee. State: FL Address : 865 S Kings Hwy
Zip Code ., ��1 S/ Fax: City: Fort Pierce State : FL
Phone No. Zip Code : 34945 FAR :
E-Mail : Phone No 772-446- 1139
Fill in fee simple Title Holder on next page if different E-Mail info@roofsbyrhino . com
from the Owner listed above) State or County License CCC1 331472
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 : NSA Name : NIA
Address : Address :
City: State : Ci t y : State .,
Zip : Phone Z i p : Phone :
FEE SIMPLE TITLE HOLDER: Not Applicable BOND � NGCOMPANY: Not Applicable
Name : NSA Name ,. N/A
Address : Address :
pity: 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 rakes 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 rues, bylaws �r and covenants that may restrict or prohibit such
structure. Please consult with year Hume Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of th is 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 mush 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 Notice of Commencement.
PF
Signature of owner/ Lessee/Contractor as Agent for Owner Signature of Contra ctor/Lice nse Holder �
STATE OF FLORIDA � STATE OF FLORIDA �.�� �y�� � .
COUNTY OFSi COUNTY t7F
Swvphysical
to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
0
Presence or Online Notarization Physical Presence or Online Notarization
this day of Lqo—�-I , 2 0,V by this AV, day of /V41G . 20,26 by
-S I/S
Name of person making statement. Name of person making statement.
Personally Known \0/ OR Pro duced identificati on Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
[Signature of N ry Publi of Flotgin L. Perez (Signature o�a ryrublic- Sta gy t rids }
� ian L. Per
Commission � �� Comm C # GG922604 iss i� o. ,�.� �' eMMe # GG9226 4
_ • � EXpI ss. ctober 14 , 2023 � • �x ites, October 4 0 3
Stu A
1 A.i Soar 10 ng# K'lotan, i %A Thm, A nrn n ii
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REViEW
DATE
RECEIVED
DATE
COMPLETED
. 5/6/20