HomeMy WebLinkAbout117 NE Airoso Blvd Permit AplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/22/2021 Permit Number:
o L. c�IUL
74
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Remove single family residence
PROPOSED IMPROVEMENT LOCATION:
Address: 117 NE Airoso Blvd
Property Tax ID #: 3419-560-0001-000-3 Lot No. 1
Site Plan Name: Block No. 73
Project Name: Family Church
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter,
(Affidavit required)
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost.of Construction: $ 10,000.00
Windows/Doors _ Pond
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Family Church-8 LLC
Name: Tony Piedra
Address: 1101 S Flagler Dr
Company: N&P Construction and Development, Inc.
City: West Palm Beach State: FL
Zip Code: 33401 Fax:
Phone No. E-
Address: 1405 Allendale Rd
City: West Palm Beach State: FL
Zip Code: 33405 Fax: (561) 318-7577
Phone No (�1)318-7575-7575
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail a a piedra80�yahoo.com _
State or County License CGC1507877
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea.
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
Name: _
Address:
City:
Zip:
Phone
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name: _
Address:
City: _
Zip: —
Phone:
Not Applicable
ate:
_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
;+h i r.lo r., rr3trnr,,cv hafnra rnmmPnrina work nr rer.ording vour Notice of Commencement.
VV IUI IG_I
na of wner/ Lessee/Contrac r as Agent for Owner
A FLORIDA
COUNTY OF &dds,
Sworn to(pr affirme and subscribed b oje me of X
Physical Presence or Online Notarization
this day of_, 2�'! by
Name of person making statement.
Personally Known �_ OR Produced Identification
Type 41dentification Pr duced
Sin ure of Notary ublic- State of Florida)
State of Florida
Commission No. �CD7 (Seal) rnton
on GG 203407
RiR
/2022
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