HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � I I I I2.I I$ Permit Number: I 1
Building Permit Application LDEE�
Dermitting
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 Resi
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: HARMONY HEIGHTS ADDN BLK M LOTS 15 AND 16
St- I IICIB Gn, n�o
Property Tax ID H: 1431-701-0228-000-3 Lot No.15-16
Site Plan Name: Block No. M
Project Name:
Setbacks) Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
❑HVAC ❑Gas Tank ❑Gas Piping ❑_Shutters Windows/Doors
Electric OPlumbing ❑Sprinklers El Generator ❑Roof 12 Roof pitch
Total Sq. Ft of Construction: L46 D S(�l -F-t.� of First Floor:
Cost of Construction: $ 500 Utilities:nSewer ❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ERM INVESTMENT (,RC)IJP LLC
Name: .IOHN A MORALES
Address:5830 WHIPPOORWILL LANE
Company: STANISLAUS ENTERPRISE INC
City: PORT SAINT LUCIE State: Fl.
Zip Code: 34987 Fax:
Phone No. 772-342-4744
Address: 5830 WHIPPOORWILL LANE
City: PORT SAINT LUCIE State: FL
Zip Code: 34987 Fax:
Phone No. 561-797-0024
E-Mail:SEICON1 @GMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: SEICONI @GMAIL.COM
State or County License: CCC1327753
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:
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 thelfirst inspection. If you intend to obtain financing, consu wit lender or an attorne efore
commencingwork or recording our Notice of Commencement.
C'_ti
Sign re of Owner/ Less /Contractor as Agent for Owner
Signat r of Contractor/L' rise Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTYOF-_�a,��
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this La day of �� : a 0� by
this Q day of 1T\e>.k�� . 20_ by
(Name of person making statement
Name of person making statement
Personally Known �;L OR Produced Identification
Personally Known �4� OR Produced Identification
Type of I'dentificatiod
Type of Identificati6n
Produced
Produced
(Signature of Notary
a
Pu. a of FlodiOaQANN MILLS
Si n
( g ature of Note R r of Flori�ll-ANN MILLS
:°; Notary Public -State of Florida
`
= • ; �l.? Notary Public - State of Florida
Commission No.
- Comrrgftil # GG 032282
'�%,',',eoi
Commission No. ;� •oe` Comml4Qemli} GG 032282
�yg •P My Comm. Expires Nov 14, 2018
Y Comm. Expires Nov 14. 2018
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Rev.8/2/17