HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:. hermit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phony: (772) 462-1553 Fax,-, (772) 462-1578
Commercial
PERMIT APPLICATION FOR: C1�B:>—zA �� _ p
PROPOSED IMPROVEMENT I OC-ATIC)K'I's
Address:
31so kit? 4-1 z�.v.�urt ;Piero
Property Tax M #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
r 61
AiCk
n
rUfij .- ,, In S �.l �
New Electrical Meter Second Electrical Mete�
CONSTRUCTION INFORMATION:
C5
Residentia.'Li X
ao
q4 5
Lot No.
Block No.
_i/ti
dzt l� i72i�"%ZLLY�1 fltf'�e S�
Additional work to be performed under this permit —check all that appay:
_Mechanical � Gas dank � Gas Piping � Shutters
_ Electric _Plumbing _Sprinklers
Total Sq. Ft of Constructiom
Cost of Construction: $ (9 .0
Generator
ray
SOV
Windows/Doors Pond
Roof Pi C�u
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height: i
OWNER/LESSEE: CONTRACTOR:
Name 0.1ndiieT Name:'Luis Quinones
Address: A (iota/ j��J vis�L�,+'�}j Company: Rhino Roofs & General Construction Corp
City: !ZLt..(trj/�� �- f11[:/C State: _FL Address: 865 S Kings Hwy
Zip Code: Fax: pity; Fort Pierce State: FL
Phone No,, -4a- ��T(��i'I Zip Code: 34945 fax:
E-Mail:Ja �y @ 'k-fivif. fiathl'116 _E ;;yr/ 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
a 2-ft I it I &% 0%S r. 0% V% 0.6 mom M ftft MI, 0% do% owk, EL a
115 -Q•UW %01 %oWl 011LI ULLIVII IM, e.JVv yr mere, a KcILurcutu Notice of commencement �is required.
If value of HAVC is $7500 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: NSA
Address:. Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: NSA Name: N/A
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.
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 and applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Flame Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, ! 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.
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 commencin work or recording Notice of Commencement.
Signature of owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
I
e
Sworn to (or affirmed) and subscribed before me of
"4" P4-day
sicai Presence or Online Notarization
this � of � 20)PI by
LL
} �1
Name of person making statement.
Personally Known �/
Type of identification
Produced
(Signature
ORIdeni�feeat�pn�e
rf; L10�711 6..
COMM. # GG9226
,,,.,. Expires: October 94
,i",,
°_ Bonded Thru Aaron N
ofiarg Public- State of Florida
Commission No.
146, q 421�-2 bl
4ft -
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
FRONT
COUNTER
Signature of Contractor/License Holder
STATE OF FLORIDA Cj_ �� c(L
COUNTY OF �T
Sworn to (or affirmed) and subscribed before me of
P ysical Presence or Online Notarization
this )6-qi day of UP., 202�bY
��l
Name of person making statement.
P
ersonally Known
Type of Identification
Produced
023
tarV .... ........ .. . .. '�4w
(Signature of
i
oR ProAli tk;tific41vian.L.Bel
am Comm, # GG921
=" '� Expires; October 1
Bonded Thru Aaron
F
otary Public- Stake of Florida )
(Seal) Commis 'ora No.0-
fn
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
(Seal)
S A TURTLE
REVIEW
MANGROVE
REVIEW
4
1
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