HomeMy WebLinkAboutBuilding Permit App 10.27.2021All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I0• a'1- 0 Oa \ 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
Commercial
CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Residential X
Address: 5312 Inlet Way, Fort Pierce, FL 34949
Property Tax ID #: 1410-502-0135-000-8 Lot No.
Site Plan Name: Block No.
Project Name: Vinyl Siding
DETAILED DESCRIPTION OF WORK:
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 _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 400 Sq. Ft. of First Floor:
Cost of Construction: $ 2,000.00 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Robert Gomez
Name: Danny Lowry Boromei
Company: Boromei Construction, Inc
Address: 12253 87th St. North
City: West Palm Beach State: FL
Zip Code: 33412 Fax: None
PhoneNo. l3\- 2jg?j _ U050 E-
Address: 420B NW 3rd St.
city: Okeechobee State: FL
Zip Code: 34972 Fax: 863.623.4314
Phone No 863.623.4314
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail melissa@boromeiconstructlon.com
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State or County License CGC1508299
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: X Not Applicable
Name: _
Address:
City:
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name: _
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
X Not Applicable
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 your Notice of Commencement.
k 1—n 6
Signa a of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Okeechobee
Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization
this 27 day of October , 2021 by Danny Boromei
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida)
�Y 0-u� Notary Public State of Florida
Commission No. (Seal) a
_ Melissa Ann Stone
:.• . c My commission GG 159396
*� of n� Expires 02124/2022
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