HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Uo L�UUC�G�
Planning and Development Services
Building Permit Application
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax.: (772) 462-1578
PERMIT APPLICATION FOR:
c
Commercial Residential X
� PROPOSED IMPROVEMENT L
OCATION:
Address: %q�J� i5cu?4/6w 2
Property Tax IDp--��
Site Plan Name:
Project N acne: LLL�UJ Lr1JC� ',l�C�✓'%
DETAILED DESCRIPTION OF WORK:
.�e.r , 0,
i-1
New Electrical Meter Second Electrical
CONSTRUCTION INFORMATION:
Additional work to be performedunder this permit —check all that a p����
� Mechanical � Gas Tank � Gas Piping � Shutters
E lectric
Plumbing
Total Sq. Ft of Construction;
Cost of Construction: $ I Q, woF0 -0- - '
_ Sprinklers
OWNER/LESSEE:
Name. ,)asepoh OiDhegsi;(
Address: '1e/05 Bea7 Sfreeto-o
City:-.f t-If P-i(frcc
F,
Generator
5-V &L-e_AzW1/
C
Lot N o.
Block No,
Windows/Doors Pond
vIR f%c;� Pitch
S . F f -�r t door:
Utilities, Sewer SepticKadin Fleight:...�IiliPi.•�i_ii•i.�.ili
State,
Zip Code: :S'��1�% Fax, -,-
Phone No. `7;2— .o?�j' -
E-Mail:' fpan iYoAf/!0�' epMail aM
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
CONTRACTOR:
Name: Luis Quionens
------
CompanyRP----
: Rhino Roofs & General Construction Corp
Address: 865 S Kings Hwy
City: Fort Pierce state: FL
Zap Code: 34945 Fax. -
Phone No 772-446-1139
E-Mail info@roofsbyrhino.com
State or County License CCC 13314.72
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
Named N/A
Address: Name: NSA
Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: NSA
Address:
City:
Zip: Phone:
Not Applicable
Name: NIA
Address:
City:
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 prier to the issuance of a permit.
St. Lucie County makes no representation that is grating a permit will authorize the permit holder to build the subject structure
which is in conflict with anu applicable Home Qwners Association rules, bylaws or and covenants that may structure. Please consult with your Home Owners Association and reviewyour deed fog- an restric�i�ns which ma �a p j��fbit such
� Y pp Y
In consideration of the grant ing of this requested perr�ii, 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 anathernon-residential
WARNING TO OWNER: Youir failure to Record a
BONDING COMPANY.,,
N Oice of improvements to your property. A Notice of Commencemenceentomment may result in paying twice for
must be recorded in the public regards of St.
Lucie bounty 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/ Lessee/Contractor as Agent for Owner Signature of contractor/License Hoiden
STATE OF FLORIDA f STATE OF FLORIDA111111!11w
COUNTY OF � LW ' COUNTY OF
Sworn to (or affirmed) and subscribed before me of Swo n to (or affirmed) and subscribed before me of
� Ph sical Prese ce or Online Notarization �P� ical Prese 'ce or Online Notarization
this � day of r {�,��- 20
by this ��1 da of � t��'-��
�v 20 by
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11A it-/u il 1, e
Name of person making statement. Name of person making statement.
Personally Known V OR Produced Identification Personal) Knowrt � CType of Identification yProduced Ident�fEcation
Type of Identification
Produced Produced
(Signature of Nota" Publit of Flo
�in L. Perez (Signature of tary Public -
Florid ���p
S14
$N,
Banded ru Aaron No4y 'W A Aft ctober 14 2021
M C , � GG9���Q'4 �
a n LQ Perez
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW---, REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/TU---J-
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