HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
J-
U ` o p �:F=
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 5301 Deer Run Drive, Fort Piece, FL 34951
Residential X
Property Tax ID #: 1313-502-0030-000-4 Lot No. 453
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Interior modifications for handicap accessibility
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric X Plumbing
Total Sq. Ft of Construction: 320
Cost of Construction: $ 16,500.00
Sprinklers _ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: X Sewer _ Septic Building Height: 1
OWN ER/LESSEE:
CONTRACTOR:
Name Zhenli L He
Name: Arthur Newman
Address: 5301 Deer Run Drive
Company: Belfor USA Group, Inc.
City: Fort Pierce State: FIL
Zip Code: 34951 Fax:
Phone No. 772-301-5567
Address: 7100 TPC Drive, Suite 450
City: Orlando State: FL
Zip Code: 32822 Fax:
Phone No 407-856-6970
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail orlando.ap@us.belfor.com
State or County License CGC04643 (St Lucie Cert # 21966)
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.
S iF�M1 TP�L Col STRE�CI QN .IEN ! INFORM T[(31�t
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: DBSS, Inc.
Name:
Address: 3662 Avalon Park East Blvd., Suite 2072
Address:
City: Or an o State: FL
City: State:
Zip: 32828 Phone 321-251-6006
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.
1"A" 'aoluk
/ I -0k.
Signature caner/ Les ee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF F101(00,
Sworn to (or affir ed) and ubscribed before me of V Physical Presence or Online Notarization
this day of MW 2001 by
Ay+kvr t l&wrnan
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
("a 101 U,0 qaAAdQ "' 11 '
(Sig&Urel5f Notdry Pu lic- State of Florida
11A
Commission No. 2 5 (Seal) 'a`iYg4�`° JACQUELYNYOLANDAGR!FFi;i
My COMMISSION # GG 257455
EXPIRES: January 11, 202.3
�9FF Bonded Thru Notary Public Vndctwt'ti—«
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21