HomeMy WebLinkAboutMISCAll APPLICABLE INFO MUST BE COMPLETL_ i`OR APPLICATION TO BE ACCEPTED
Date: Permit Number:
�; •: SCANNED
_.....__.-... + K...:...x__- ..... w ._ Building Permit Applicationt. Lucie County
Planning and Development Services S
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: /I ('-� C�Cff °-e—ki �!/lC_/0 C:�o d P .
Legal Description:
PropertyTaxlD#: 1-k 51)-,V I-- OOd1- 1 13(3-
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No..
Block No.
c!
ditional work to be pertormed under this permit- check all that apply:
_Mechanical _ Gas Tank Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing — Sprinklers Generator Roof
Total Sq. Ft of Construction: _
/
Cost of Construction: $ (�Q0 1
00
Sq. Ft. of First
Utilities: —Sewer —Septic Building Height:
Name_C�i�IU/ ffa�) Ali//S'1
Address: - SaY, a_ Lv
City: �P c(11," Q ,�- State:
Zip Code: 33 Yo Jr' Fax: 5(v / Jr SZ 53 0 q
Phone No. % l 2 5 L/ 0356
E-Mail:_ (,ECG r 1 +A C. aol , rom
Fill in fee simple Title Holder on next page ( if different
from the Owner listed 'above)
Address:.
City: State:
Zip Code: Fax:
Phone No
E-Mail
State or County License
IT value of construction is lSuu or more, a RECORDED Notice of Commencement is required.
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GINEER: Not Applicable
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MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
State:
City: State:.
Zip: Phone
Zip: Phone:
SIMPLECity:
FEE HOLDER: Applicable
BONDING • 1 1
Name:
Address:
Address:Name:
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 hrestrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions wich 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 your Notice of Commencement.
Sig —nature of O n essee Con Tract r as Agent M70`wner
STATE OF FLORIDg7
COUNTY OF m ��
The forgoing instrument was acknowledged before me
this--J--dayof IJ000'MLQ y 20_L� by
( J ro L UU_r)10_r MI i I s'o n
(Name of person acknowl g )
(Signature of Not lorida )
Personally Known OR Produced Identification X
Type of Identification
Produced L o
YENISEY GUERRA
Commission No. `-•s °'s MM@OMISSION *FF10001
EXPIRES March 10, 2011
! �9 Boa n9 G•tl Gln.irfaNn9arvC�tuir� rim
Signature of Contractor/License. Holder
STATE OF FLORIDA
COUNTY OF '
The forgoing instrument was acknowledged before me
this day of , 20_ by
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known _
Type of Identification
No.
OR Produced Identification
(Seal)
REVIEWS
I
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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John M. Arribas Jr., P.E.
10980 S. Ocean Drive Jensen Beach, FI 34957 (772-229-3057)
St. Lucie County, Florida
Building & Code Regulation
2300 Virginia Avenue
Ft. Pierce, Fl. 34982
Re; Permit No. SLC
44 Aqua Ra Drive ---
St. Lucie County
Attn; Debbie Isenhour
Gentlemen:
November 2, 2016
The undersigned has been engaged by the owners of the above said property to verify the
completion of the works conducted at the above mentioned address. I did not witness any of the
work done and my report is based solely on a visual inspection. No invasive tests werr,
conducted. This report is based on personal observations and accounts submitted by the owner.
The works completed are basic interior aesthetic remodeling. The work consisted of:
Placing laminated wood floor over existing subsurface
Placing decorative wood paneling on existing walls
Replacing sagging ceiling several rooms
Replacing a ceiling fixture (fan with light)
Replacing a ceiling light
Remodeling bathroom with tiles
Replacing several plumbing fixtures
Replacing four exterior windows with impact glass (1)
(1) Impact windows were an approved product at the time of installation
There is no evidence or indication that the Structural System, Electrical System or Plumbing
System was altered or compromised in any way other than to make the necessary connections
The owners of the property have attested that no works were conducted on the aforementioned
systems.
Respectively submitted,
ohn M. Arribas Jr., P.E.
Florida Certificate No. 7032