HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Appli
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
JUN 19 2018
'ermitting Department
St, Lucie COY, FL
Residentia
1 PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
PROPOSED IMiPROVEMENT LOCATION
r
Address: 17900 Wagonwheel Lane
Legal Description: CARLTON COUNTRY ESTATES (PB 46-29) LOT 4 (5.241 AC) (OR 3820-61)
Property Tax ID #: 3211-701-0006-000-1 Lot No.4
Site Plan Name: Block No.
Project Name:
?Setbacks Front Hack: Right Side: 7 a Left Side:
DETAILED DESCRIPTION OF WORK
Pour concrete slab 6" thick with 12x12 footers and (1) #5 rebar
30
fiberer mesh C
50x60 slab dimensions
CONSTRUCTION. IN FORMATION:.
Additional work to e narrormed under this permit -check a apply:
0HVAC OGasTank ❑Gas Piping Shutters a Windows/Doors
11 Electric 0 I-.�l Plumbing Sprinklers _ Generator Roof Roof pitch
Total Sq. Ft of Construction: i 30-04�:> S . Ft. of First Floor:
Cost of Construction: $ �k�'"'-/ L�Utilities:� Sewer O.Septic Building Height:
01111 :.NER LESSEE .
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:CONTRACTOR:"
Name &V.
Name: Jose Vides
Address: A O
Company: JosB Concrete Perfection
City: W L
State:
Address: 383 SW North Shore Blvd .
Zip Code: `t Lkc Fax: sr
_
City: Port St Lucie State: FL
Phone NoA h 2 �
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Zip Code: 34986 Fax: None
E-Mail: •,*,
Phone No. 7728125066
Fill in fee simple Title Holder on next
page ( if different
E-Mail: losbconcreteperfection@hotmailcom
from the Owner listed above)
State or County License: 25230
IT value or construction is �izsuu or more, a RECORDED Notice of Commencement is required.
S1tP#�l�'jVtj*NTA CO�JS�fRCTIQN t.tEN LAW tNtii�MATtO,tn
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:Jose Vdes
Address: 179o0 Wagonwheel Lane
Address:
City: State:
City: Port St Lucie State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:383 SW North Shore Blvd
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 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 vour Notice of Commencement. A
-4 kd'k
Signature of Owndkrl Lessee/Contr or as Agent for Owner
Signatur o C ntractor/License Holde
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
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COUNTY OF
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The f r ing inst ent was acknowledged before
this day by
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The f ing i �nent was acknowledge efor
this day 20 by
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Name of pers eking statement
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Name of person aking statement
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Personally Known OR Produced Identificatiw
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Personally Known Produced Identifica
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Type of identification
Type of Identification
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Produced'°�:
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(Signature of Nota Public- State of Florida)
(Signature of Notary(yublic- State of Florida )IF
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
I
DATE
COMPLETED
tev. 8/2/17