HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/16/19
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number: ��a�JO 1dsO
SCANNED
BY
St. Lucie County RECEIVED
Building Permit Applicatio APR 1 6 2Qi9
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Commercial Residential XX
PERMITTYPE: Concrete ribbon footing with paver install
PROPOSED IMPROVEMENT LOCATION:,
Address: 5104 Sunset Blvd
PropertyTaxlDtf: 3402-608-0489-000-0 Lot No. 3 & 4
Site Plan Name: Block No. 53
Project Name: tree �ti SSA �Q
DETAILED DESCRIPTION OF WORK: ]
Install concrete ribbon footer for back D
Install pavers for entire area
CONSTRUCTION INFORMATION:
30x20 with 8x8 (1)/i5 rebar
Additional work to be performed under this permit —check all that apply:
Mechanical
Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction: 600
Cost of Construction: $ 2,000.00
_ Gas Piping
_ Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Windows/Doors
_ Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameTracy Bright
Address: 5104 Sunset BLvd
Name: Jose Vides
Company: JosB Concrete Perfection
City: Fort Pierce State: _
Zip Code: 34982 Fax: None
Phone No.7722406170
Address:383 SW North Shore Blvd
City: Port St LUcie State:FL
Zip Code: 34986 Fax: N/A
Phone N07728125066
E-Mail:josbconcreteperfection@hotmail.com
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
E-Maillosbconcreteperfection@hotmail.com
State or County License 25230
It value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
If value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL'CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
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Signature
STATE OF FLORIDtA ---�7— —, I STATE OF FL
COUNTY OF Sk.l.vctQ I COUNTY OF.
The forgoing instrument was acknowledged before me The for oing instrument was acknowledged before me
this\� day of Q A C� i 20A by this day of q D i� 204 by
'So3P V \XeS I Sass V i Xe,S
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 sr L, L Produced fl
(Signature of Notary Publi6JState of Florida) (Signature of Not; , (i:$Sta`1�
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Commission No. 6'-ya.. go sion No. Sr i rS.Cy d tlw Notaryf
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