HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1T� 5 Permit Number: 1507-0�9
RECEIVED JUL 3^1 1015
64Building 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 4/111
PERMIT APPLICATION FOR:
I A`r(cx1'
Address: 4/90LI SC-4-6P�E P P T— P—T &CC-r. , {—L 351982
Legal Description: g t K_ y 2 - Cy t— I o - u Ni _ P-.I vGi a-g--rte , �LAT a ook ry
Q AIGC Tc
' Property Tax ID#: 3402- 6®Y - 0126- OOU-y Lot No. I0
Site Plan Name: P-avS e Block No. (F 2-
Project
Project Name: S CAA ea�p E t-�oQSE.
Setbacks Front Back: Right Side: Left Side:
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Additional work to�be pertormedd under this permit-check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Co•bd Utilities: —Sewer Septic Building Height:
Name ' iro O N m A-Q.LGrC Name:, D7 - t Z v 9 c-r-1;% z- 0- =SaSE E t_4-f
Address: .490 SCAGC-&-PE- 0� Company: )-C-LA �-tv�
City `Pf Pi-i✓e-CE. State: i-1 Address: 2 5Y . Det. rti2.
Zip Code: 5'�°i S 2 Fax: City: 6 E�6 AS T-3-4-1 State: T-1
Phone No. - 7_04- 63 2 6 Zip Code: Fax: a424a'9 2121
E-Mail: Phone No qW- 20-9- 7.123
Fill in fee simple Title Holder on next page (if different E-Mail fns 4L (?de-le C4,
from the Owner listed above) State or County License C6 c 14-1414-1
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
�.• l' ikG�fYax �� r a -"151,
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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 thepermit 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 OWN
ER. , ure to Record a Notice of Commencement e'u+tjn your paying twice for
improvements toNoticeof Commencement must b recorded and\posted on the jobsite
before the firs section.rin
o tend to obtain financing, c h lender-,gr \attorney before
comme w rk o ecor o r Notice of Commencem nt.
Signature of Owner/Less e t Signature of Con ractor/ ' nse older
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF S-( . COUNTY OF S+-Low \.Q
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this%\ day of 'sO�y 20NS by this%\ day of 20�5 by
(Name of person acknowledging) (Name of person acknowledging)
(-Signature of Notary Pu lic-State of Florida ) (Signature of Notary Public-State of Florida)
Personally Known OR Produc tific t Personally Known OR Produced Ident'fi
Type of Identification t EPNNp st`a o�Ft0�20�6 Type of Identification DE bNcP
�.(D D �e°�6.0� Produced �
Produced .fl L P� fie° 2
P� des 65a� 55(x. ,ni:y�i, Nota ExPtces 65a�6�
ty m:\Sso° E �°tatyA Commission No. l,G�bs' `• '_My co �°�#\on�N°1a�yAssn•
Commission
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'�i r4?F OF,�
REVIEWS
F0 ZONING SUPERVISOR PLANS VEGETATIONJ�A SEA TURTLE_ .- MANGROVE
MNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014
Planning&Developmentsenrices+ ,,.t ASBESTOS NOTICE
;Building&:Code Regulal3on;Divigion
Z300 MrginiaRv'enue;
Fort'Pierce;F"A
Phone{772j462 2172 .Fax(77x2)462-6443
Asbestos Notice to Contractor
July 31, 2015
DE LA HOZ BUILDERS INC
JOSE DE LA HOZ
258 DEL MONTE RD
SEBASTIAN, FL 32958
FILE COPY
RE: Building Permit Number 1507-0491
It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department
of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal
law.
atu
AE5
Date
7/31/2015 3:50:42 PM