HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/28/2017 Permit Number:
Building Permit Application
Planning and Development Services NOV 0 3 2017
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Renovation El -
PROPOSED
IMPROVEMENT LOCATION:
Address: 67-7-0 2?-1.06 LAek6 `%(ZkAL-fa 160FLT PtMC.S Vt- 3y-q l
Legal Description: Portofino Shores - Phase Three (PB 43-40) Lot 365 (OR 2419-2033)
PropertyTax ID #: 1312-503-0138-000-1
Site Plan Name: Fleurima
Project Name: Fleurima
Setbacks Front / Back:
/ Right Side: / Left Side: /
Remove and replace kitchen cabinets
Minor Drywall repairs and paint
Detach and reset kitchen sink
Lot No.
Block No.
'CONSTRUCTION INFORMATION:
Aciclitional work to be nertormed under this permit —check all apply:
11HVAC LJ Gas Tank ❑Gas Piping _ Shutters a Windows/Doors
11 Electric ® Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 260 S Ft. of First Floor: 1,513
Cost of Construction: $ 10,767.69 Utilities: II Sewer 0 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name KIET'cLy V L150(L%11A
Name: S'iEVE
l?tC t4#J
Address: (ZZ O SPf-W-� 6 (AKE 1 t(t4 NLE
Company: RAP-+-
ftrosPOPSF TeA-m LLre- .
City: 'Fo(L'r. Q kE'2Gb State:
Address: J_Z S0
At. AerigyewS AVE
Zip Code: 1445 l Fax:
City: QOAPAN O
BGAt rr Stater
Phone No. (11 Li 10 6 - N4bZ
Zip Code: 1306.1
Phone No. (7Sci
Fax:
boo— $ 100. • aFs4sli
E-Mail: (.Cyt'%rA@a V1o$rA; k . CO/I-x
Fill in fee simple Title Holder on next page ( if different
E-Mail:
from the Owner listed above)
State or County License: GGG nLW71;5'
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIQN:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
address:
Address:
City: State:
City: '
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: 1K Not Applicable
BONDING COMPANY:
V 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.
S . Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
w ich is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
st ucture. 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
commencing work or recording your Notice of Commencement.
t
ignatur O er/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA `�
COUNTY OF �A/gi/�4-� ielV4W
COUNTY OF �Q�C
The forg7o g instrument was acknowledged before me
The forgoing instr ent vyas acknowledged before me
this /�—day of ��$t�Q 20L7 by
this. day of 7' 20j7 by
-trLY
"�%i'l - VV"-C
Pt_EuA61MA-
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Name of person making statement /
Name of pers n making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced neK.►W i 1ywS I
Produced
(Signatu A of Notary Pub -
ignature of Notary Pub
pRV P(;8 4 TOMAS RUIZ DE LUZURIAG
Wq,_ Notary Pubic State of Florkla
Commission No. / °= I
• _ NS,� public -State of Florl
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a tAr1 (i�p�}�
mmission No. MYCGo}"nrci�eilonGO102013
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��9* 4 Commission # FF 178175
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V FXF 08104/202t
F �oI My Comm. Expires Nov 19, 20
8
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ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
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REVIEW-
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17