HomeMy WebLinkAbout316 Shady Ln Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: NSA Name: NSA
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: N/A Name: N/A
Address: Address,.
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVITO. Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work orinstallation 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 died for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that ! will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie bounty Amendments.
.6
The following building permit applications are exempt from undergoing a full concurrency review: roam 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 your Notice of Commencement.
Jill
Signature of Owner/ lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA ,,
COUNTY OF � � � _ _.
Sworyiwto (or affirmed) and subscribed before me of Sw
y
Vqrn to (or affirmed) and subscribed before me of
Phnl sical Pres ce or Online Notarization P sisal Prese ce or Online Notarization
thisV,
dayof � � e;"
i 2QXd by this day of �- FAtL 202T by
I k? 61
Name of person making statement. Name of person making statement.
Personally Known '%**/ OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Type of Identification
Produced , Produced
(Signature of Flo y Puf3lic- Stat unan �3 ignat o Notary Public fI orid •
COMM*#GG92 604 � :�� CoMma#GG922604
Pssion NaEx�pc�ob�r 14,202
commission1�3: ac#obey 1 , =, ,;
'���,,,�►,,,•���`' Bonded Thru Aaron Nit '��,�;�;�;,,,•��Bonded Thru Aaron Notar
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/zu
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
V7
L= E C; a 0 D
P rr Nt umber:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
PERM APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 5el(V
Property Tax ID #:3�'i�� -
Site Plan Name:
Project Name:
't
DETAILED DESCRIPTION OF WORK:
Residential X
z t o l new efai �� w�r th
Pee A hGt< Uc�i-I(��ae�nt
New Electrica� Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that appBy:
Mechanical _Gas Tank _Gas Piping � Shutters
Electric
Plumbing
Total Sq. Ft of Construction: a 3) .5
Cost of Construction: $ 1'5) 008
�„ Sprinklers
Generator
Lot No. ( O
Block No. �oZ
Windows/Doors Pond
✓Roofr 3jia Pitch
Sq. Ft. of First Floor:
VC
Utilities; Sewer S e p tic Buil in Height I
OWNER/LESSEE: CONTRACTOR:
Name Name: Luis Quinones
Address: 31 V1 act1, Ln Company: Rhino Roofs & General Construction Corp
City: I-i)d� _�(AI/'►�i' L� t State: Address: 865 S Kings Hwy
Zip Code: t} 5.3k Fax: pity; Fort Pierce State: FL
_M,
Phone �9a. �'�Q� ba�-a(}dL� Zip Code: 34945 Fax:
E-MaiL• �'Qh(4h'�S�Yt�li .Vlbt7.0 Y�-L Phone d�lo772-446-1139
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
,T
vague
or
construaion is
zsuv or more, a RECORDED Notice of Commencement is required.
1#
value
of
HAVC is $7,,500
or more, a RECORDED Notice of Commencement is required.