HomeMy WebLinkAboutBuilding Permit Application-- t
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �f
Date: 0% Permit Number:
RECEIV-7D SEP 18 2017
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 Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line -SA dA
PROPOSED IMPROVEMENT LOCATION:
Address: 5916 Pinetree Dr
Legal Description: INDIAN RIVER ESTATES -UNIT 02- BILK 12 S 46.5 FT LOT 6 AND ALL LOT7 (MAP 34/11S) (OR 3000-2917)
Property Tax ID #: 3402-603-0175-000-1
Site Plan Name: PineTree
Project Name: Pine tree
Setbacks Front 185 Back: 76
-DETAILED, DESCRIPTION OF WORK:,
Right Side: 59 Left Side: 26
Lot No. LOT 6 AND ALL LOT7
Block No. 8LK,2546.5Fr
p 464'T Install Concrete pad 40x24 with (2) # 5 REBARS
1t'A 11.; otJ}ass
CONSTRUCTION INFORMATION;
Add itiona I work to bortormed under this permit - check all apply:
0HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
11 Electric ElPlumbing Sprinklers Elenerator 0 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
S Ft. of First Floor: _
Utilities:] Sewer O Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Roxa A Cidaru
D (^l
Name: Juan Moran
Address: 5916 inetr a Dr 59 1(0
W-0-i-"e Df
Company: Cove Concrete & Co LLC
City: Fort. pierce P
State:Fl
Address: 9156 104th ave
Zip Code: 34982 Fax:
3"-TZ
City: Vero Beach State: FI
Phone No. 77245 3434
Zip Code: 32967 Fax:
E-Mail:
Phone No. 772 4533434
Fill in fee simp Title Holder on next page (if different
E-Mail:
from the Owner listed above)
State or County License: CRC1331029
If value of construction is $2500 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:
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine work or recordine vour Notice of Commencement.
�/O"D �3e, '/10�1 s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of-Contractor/License Holder
STATE OF FLORIUNTYOF Sr,i L-%)c-%*,
The fo going instrument was acknowledged before me
thisk'i day of 4 % 0 20 11 by
STATE OF FLORIDA
COUNTY OF Sk.
The for ping instrument was acknowledged before me
this_16 day of fie' , 20 LL by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary
Personally Known _
Type of Identification
Commission No.
Revised 07/15/2014
State of Florida )
OR Produced Identification
iced V-" ti. h L ._J_, ,
MY��—MARIE GIVENS
SSION # GG 022023
EXPIRES. P u
.- ti a UrlderWdlere
(Signature of NotaryPublic- State of Florida )
Personally
Type of Identifi " ti�?� uced IE GIVENS
°MYCOM
"-� PIRES: Dece��f�r 1 2020
Commission NO ThNNotaryPldil�C�kerwflters
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