HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLrEf INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �oc•' ' 1 Permit Number: 1-7 1,2 • v 3�_�
•
Building Permit Application ®EC' t 2017
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: Renovation
PROPOEfl �MPRC►EMEiVT LOCATiQt t 1 xgx r �n
Address: 7406 San Carlos Dr, Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK -UNIT 1- BLK 8 LOT 11 (MAP 13/14N) (OR 843-638; 2056-563)
Property Tax ID #: 1301-601-0139-000-5
Site Plan Name:
Project Name: Boatwright - Hurricane Loss Mitigation Repairs
Setbacks Front Back: Right Side: Left Side:
Lot No. 11
Block No. 8
Replace front door, Replace garage door, Install Accordion Shutters at windows, Replace roof shingles
yuZi?ScAaE ;)4-+1AGE
�HVAC L �I Gas Tank
Electric 0 PlumbinE
Total Sq. Ft of Construc
Cost of Construction: $
Generator
F✓ Winc
R1 Roof
tion: S Ft. of First Floor:
$19,950.00 Utilities:[]Sewer OSeptic Building Height:
Roof pitch
Name Vanessa Boatwright
Name: Jose De La Hoz
Company: DE LA HOZ BUILDERS, INC.
Address: 7406 San Carlos DR
City: Fort Pierce State: FIL
Address: 258 Del Monte Rd
Zip Code: 34951 Fax:
City: Sebastian State: FL
Phone No. 772-971-7369
Zip Code: 32958 Fax: 772-589-8127
E-Mail:
Phone No. 772-228-9723
E-Mail: hilda@delahozbuilders,com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CGC1514151
IT vawe oT construction is :�2500 or more, a RECORDED Notice of Commencement is required.
SIJPPL�MENTf�L�C0�15TR�CTtON
L1E�1LA�Itt �NFORIUTATIaN� ����
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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:
el 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 your paying twice for
improvements to your property. A Notice of Commencement must be ded and posted on the jobsite
before the first inspection. If you intend to obtain financing, con sl}k with le r or an attorney before
commencing work or recording vour Notice of Commencement/ c'
ti �Cti U'40 ' 6s t kJi,;
Signature of Owner/ Lessee/Contractor as Uent for Owner
STATE OF FLORIDA
COUNTY OF s7 (- 0 ez E
The forgoing instrument was acknowledged before me
this It day of 1i t-C E*r-r 9 _ 20/-?' by
t/A-NCSSA 8Q41—u,esGr41-
of CorftWEtor/liMe Holder
STA FLO A
COUNTY O 2A;" v�2
The forgoing instrument was acknowledged before me
this /3 day of r) &C61'8 &4— , 20 /-7 by
JI-IfE be " f4-oZ-
Name of person making statement Name of person making statement
Personally Known ✓ OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
b "t, /-�' - L:�Q6�� -
(Signature of hotary Public- State of Florida) (Signature of Notary Public- State of Florida )
Commission No. r 9 LA Nei commission 9 No. / 7 (O
y 9/ �a wr'�ISSIpN 0 FF 01911I F S
EXPIRES Falorwq 20. 2=
Meiaiao,a
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA T
COUNTER REVIEW REVIEW REVIEW REVIEW REV
DATE`�,
RECEIVED I
DATE
COMPLETED
Rev. 8/2/17
kTi'
RHINA A V A00
Notary Public - St a of Flor
My Comm. Expl a ov 9, 21
V omm as n 17506!
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