HomeMy WebLinkAboutBuilding Permit Application 7.
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 X
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEME,NT.LOCATLON'1 ,-
Address: 226 NE JARDAIN RD PORT SAINT LUCIE, FL 34983
Legal Description: RIVER PARK-UNIT 9-PART B BLK 73 LOT 21 (MAP 34/28N)(OR 1674-2256)
Property Tax ID#: 3419-565-0027-000-6 Lot No.21
Site Plan Name: Block No. 73
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED'-DESCRIPTION_OF WORK
CONSTRUCTION IN-F.ORMATION 4
5_,, , t
Additional work to be nertormed under this permit—c ec a appy:
HVAC Gas Tank Gas Piping _Shutters Windows/Doors
❑
❑Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 2.i% �Y Z Sq. Ft. of First Floor: 2 , (3 Z-
Cost of Construction:$ l Z0,01 Utilities:R Sewer❑Septic Building Height:
OWNER/LESSE'E '� w�;CONTRACTOR: _ i ' `
Name MAURICE& ARLENE PLANTE Name: MAURICIO ORELLANA
Address:226 NE JARDAIN RD Company: ONE CONSTRUCTION&ROOFING CONTRACTORS
City: PORT SAINT LUCIE State:FL Address: 3437 SW EUROPE ST
Zip Code: 34983 Fax: City: PORT SAINT LUCIE State:FL
Phone No. Zip Code: 34953 Fax: 772-336-9379
E-Mail: Phone No. 772-519-2449
Fill in fee simple Title Holder on next page(if different E-Mail: ONECONSTRUCTIONSERVICES@YAHOO.COM
from the Owner listed above) State or County License: FLORIDA
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCTION LIEN,LAW INFORMATION_.
DESIGNER/ENGINEER: x—Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: x 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 Counter 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 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/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF I -!�T L 0 C l�. COUNTY OF 'jT Z v c,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-0 day of N�J E�1 L 20 �by this�day of mad�kC�f2- ,20 1'� by
lqp-v7,161 b �LLN,I�� ��t,/1Z-1 Gly L�Yz v�
(Na rs nowle (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced :V Mj Z n. LI.C,Cji 4 1; Type of Identification Produced
��' S yq (Seal) ission No.
Commission No. Z j WIAILTER G011t! S�
MY COMMISSION 0 FF `?� WAFTER GOI�
25171 :�: .•:
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uo»aoe.olsa F „. EXPIRES December 17. 9
Revised 07/15/2014 � 440713wo,m cm
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DATE
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