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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 6/22/21 Permit Number: 21ro d�1GDC `- O l Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential XXX 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: driveway repair PROPOSED IMPROVEMENT LOCATION: Address:'601 Beach Ave Port St Lucie Property Tax I D#: 3419-510-0178-000-9 Lot No. 13 Site Plan Name: Block No. 16 Project Name: DETAILED DESCRIPTION OF WORK: Repair damaged concrete in driveway 3000psi with fiber mesh 4"thick approx 16x20 Add concrete to left side of home 14x40 3000psi with fiber mesh 4"thick 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 _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ 1925.00 Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Bass-Terpstra,Marceline M Name:Jose Vides Address: 255 North Pleasant Street Company:JosB Concrete Perfection City: Watertown State:_ Address: 383 SW North Shore Blvd Zip Code: 13601 Fax: None City: Port St Lucie State:FL Phone No.772 240 6170 Zip Code: 34986 Fax: None E-Mail:None Phone No 772 812 5066 Fill in fee simple Title Holder on next page(if different E-Maillosbconcreteperfection@hotmail.com from the Owner listed above) State or County License25230 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: 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 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 our Notice of Commencement. Signature of Owner/Less ractor as Agent for Owner Signature of Contractor/Li nse STATE OF FLORIDA �y� STATE OF COUNTY OFORIDA � L COUNTY OF f Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of P ysical-Presence or Online Notarization Physical Presence or Online Notarization this ov nX� _ ,202J by this ay Of 2020y6y v Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification - Type of tificatioin Produced P r o d u d L OtPRYaG'G r5lPRY PGe�. EL =Y :_State of FEN VA (Sig ota ' Yiao&t �) fission #GG 270079 p�mmissio G 270p7g1C My Commission ''-" t©66r n Ek I C o. Oo Expires ( all Commission No. _. . d22 res ( al) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.5/6/20