HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
L(f c u E;L
COO ��r�"
E O R� I DD
Permit Number:
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
PERMIT APPLICATION FOR:
Commercial
PROPOSED IMPRUVEMENT LOCATION:
Residential X
Address: �l(��1 3�q)f?
�
P ro pe rty Ta x I D #:�,'9�(J' ���— OV -3 Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
1p,
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Mechanical I Gas lank � Gas Piping
Electric � Plumbing � Sprinklers
Total Sq. Ft of Construction:A�f) A7)
Block No.
1VAA1-0-
Shutters Windows/Doors Pond
Generator V00or �
Roof V/;Z Pitch
S - Ft. of First Floor:
Cost of Construction: $ Yq Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name_ Name: Luis Quinones
Address:-4yC9 1AC1 yep- V a4(C. LAILL Company: Rhino Roofs & General Construction Corp
City: pt-el'C.2 State: $rL Address: 865 S Kings Hwy
Zip Code: � `���� Fax: City: Fort Pierce State: FL
Phone No,, 1114? - �' ffa - T/5;(o Zip Code: 34945 Fax:
E-Mail:. �j'I LC�'1 . 12&(0,' gmj�&- � CO'/n 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 CCC1331472
If value
of
construction is
2500 or more, a RECORDED Notice of Commencement es required.
If value
of
HAVC is $7,500
or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN SAW 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,, NSA
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 theissuance of a permit.
St. Lucie County makes no representation that is granting a hermit 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 prohib'st 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 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 Notice of Commencement.
Signature of Owner/ Less ee/Co ntracto r as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA (�y STATE OF FLORIDA �� L
COUNTY OF cif-LI.�QI � COUNTY OF
Swto Oar affirmed) and subscribed before me of
Physical Presence or online Notarization
this day of 20� by
ell 1
I 111 C' ( 11"", o 9's
Name of person making statement.
Personally Known
Type of Identification
Produced
(Sipnature of
commissio
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
v.
OR Produced Identification
qP V P ���, � Fionaijian L. Jerez
£ Cwms # GG922604
0. ZExo October 14, 202
l;,� Bonded Thru Aaron Notm
I I - I
FRONT ZONING SUPLRVI5UK
COUNTER REVIEW REVIEW
Sworn to (or affirmed) and subscribed before me of
Ph sical Presence or online Notarization
this�day of 202eby
a�
&ti'
Name of person making statement.
Personally Known ^a "��A,.�^'"^'"'^*'� +°
^'^n
Type of Identification
Produced
(Signature of Notar
Commission N
PLANS
REVIEW
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:October 14, 2
REVIEW
SEA TURTLE
SEA TURTLE
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REVIEW
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