HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: • � • 1 t �r[ , Permit Number:
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=RECEIVED����Building Permit ApplicationPlanning and Development ServicesBuilding 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: Other
GG A NNE
PROPOSED IMPROVEMENT LOCATION:- RV ,
Address: 4422 HIGHWAY A1A, Ft. Pierce, FL 34949 S3, Lucie COI
Legal Description: QUEENS ISLAND PRESERVE (PB 60-4) BLK A LOT 3 (OR 4101-2047)
Property Tax ID #: 1414-704-0004-000-3
Site Plan Name: Queen Island Preserve
Project Name: Aquavista
Setbacks Front N/A Back: N/A
Right Side: 7.5 R Left Side: 7.5 ft
Lot No. 3
Block No. A
DETAILED DESCRIPTION'OF WORK:
Piling foundation permit only for future family residence.
COMTa wor to e e orme under tispermit—check all apply:
�HVAC Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction: 3700
Cost of Construction: $ 50,000
Piping _Shutters ❑Windows/Doors
nklers Generator 0 Roof Roof pitch
_ S Ft. of First Floor: 3700
UtilitiesSewer11Septic Building Height:
OWNER/LESSEE: ,
CONTRACTOR`
Name Venetian Administration, LLC
Name: Ublado Blanco
Address:7400 West Flagler Street
Company: Ubaldo Blanco GC inc.
City: Miami State: FL
Zip Code: 33144 Fax:
Phone No. (305)785-7785
Address: 437 Golden Isles, Apt 8F
City: Hallendale State: FL
Zip Code: 33004 Fax:
Phone No. 786-512-4484
E-Mail: bonvecchio@yahoo.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: vortega@sionhomes.com
State or County License: CGC 047289
it value of construction is 5Z500 or more, a RECORDED Notice of Commencement is required.
SUPP_LEM_EN_TAL_CONSTRUCTION LIEN'LAW
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
ZNot Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
i
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_ of Applicable
Address: 437 Golden Isles, Apr BF
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 our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORID
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STATE OF FLOR,
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COUNTY OF �(__
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COUNTY OF PCs
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of
20� by
this day of �rt�an �. 20_ by
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
(Signature of Notary u ' " of Florida
3+° Ndhry Pu Ilc • Anti of Flodda
(Signature of Notary, UDI ate or FiondWIA DW
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Dec 13, 2020
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SUPERVISOR
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VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
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DATE
COMPLETED
Rev.8/2/17
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