HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO( `MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 ! �1 J/ Permit Number: �� V
Building Permit Application
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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 121 SE Solaz Avenue, Port St Lucie, FL 34983
Legal Description: RIVER PARK UNIT 5 BLK 50 LOT 38
Property Tax ID#: 3419-540-0261-000-1 Lot No.38
Site Plan Name: Block No. 50
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
z 3 g 9 sqI- 4 `Sl s 9//2z`o��
CONSTRUCTION INFORMATION:
Additional work to be nerformed under tis permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric ❑ Plumbing Sprinklers FIGenerator W1 Roof
Total Sq. Ft of Construction: 2,006 S Ft.of First Floor:
Cost of Construction:$ 9,000 Utilities:Sewer OSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name RHA 2, LLC Name: ALEJANDRO ONDARZA
Address:3505 KOGER BLVD., STE 400 Company: BIG O ROOFING AND CONSTRUCTION, LLC
City: DULUTH State:GA Address: 8885 OKEECHOBEE BLVD.,#304
Zip Code: 30096 Fax: City: WEST PALM BEACH State:FL
Phone No. Zip Code: 33411 Fax: 786-345-0707
E-Mail: Phone No. 305-496-7045
Fill in fee simple Title Holder on'next page(if different E-Mail: INFO@bigOroofingandconstruction.com
from the Owner listed above) State or County License: CCC1330590
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: .
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.
s
_Signa re of Owner/ Agent SignatLeeof Contracw1gricense Holder
STATE OF FLORM'141
STATE OF FLORIDA
COUNTY OF COUNTY OF PALM BEACH
The forgoing instrumggt was acknowledged before me The forgoing instrument was acknowledged before me
this/ day of J ")1 y, 201 S"by this 12 day of JULY 20 by
A�,i i&1 6 D14 6421_�� ALEJANDRO ONDARZA
(Name Wperson acknowledging) (Name of person acknowledging)
mac— `GGc.c-
(signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Knowny OR rpPd IderfiV�l'4f��ODRIGUES personally Known �OR ro uce
r°'` '�� MY COMMISSION#FF190 82 e dYp�h SUAD HANI RODRIGUES
Type of Identification Produced : ; Type of Identification Produce >•°� ..�8
MIKES:jA14 20,2019 "£ #FF190782
39� G�'Oejt e €
0.a N through 1st State Insuranc pw aF � IS:JAN 20,2019
Commission No. �°��� Commission No. a �a � Bon ro gh 1st state Insurance
Revised 07/15/2014
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