HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06-01-2016 Permit Number:_
EEC
VED• 10" -�_ _00
JUN 17 HM
Building Permit Application
Planning and Development Services PERM 1171 NG
Building and Code Regulation Division
St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT- LOCATION::-
Address: 6013 CASSIA DRIVE
Legal Description:
Property Tax ID#: 3402-610-0453-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED. DESCRIPTI
ON O:F WORK:
REPLACE WATER HEATER.
m an V our l; e q like, �.��c ����'
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CONSTRUCTION INFORMATION.
Additional work toEee r orme under this permit—check a appy:
HVAC _I Gas Tank ❑Gas Piping _Shutters a Windows/Doors
Electric ❑✓ Plumbing Sprinklers 11 Generator E] Roof
Total Sq. Ft of Construction: S�Ft.I of First Floor:
Cost of Construction:$ 400.00 Utilities. Sewer ElSeptic Building Height:
OWNER/LESSEE. CONT' CTOR:e
Name .r�s/,moi ame: GUSTAVO VELEZ
Address: �`� `p, � r / Company: REGOSA ENGINEERING SERVICES
City: State: C Address: 15700 NE 2 AVE
Zip Code: jr �_ Fax: City: MIAMI State:FL
Phone No.l wep Zip Code: 33162 Fax: 305-945-4367
E-Mail: Phone No. 786-262-2964
Fill in fee simple Title Holder on next page(if different E-Mail: CONTRACTORWORK@GMAIL.COM
from the Owner listed above) State or County License: CFC-1427292
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: Roca Housing Solutions LLC Name:
Address: 419 WEST 49 STREET,SUITE 217 Address:
City: HIALEAH,FLORIDA City:
Zip: 33012 Phone: 305-338-1669 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 Amendmen .
The following building permit applications are exempt from undergoing a full concurrency review: oom dditions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to an ther n�n-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may resul in you paying twice for
improvements to your property. A Notice of Commencement must be recorded d pted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender r atorney before
commencing work or recording our Notice of Commencement.
_
Signatu
ref Owner/'Lessee/Agent Signature of Contract is a older
STATE STATE OF FLOR
COUNTY OF A4IA-44t--rb Ai)E COUNTY OF Mwni-oAOE
Thefor oing instrW..�ent was acknowledged before me The forgoing instrument as acknowledged before me
this Pi day of ,J✓A7e 20 &.by this ' day of �uNE 20 by
//L)A i 0- Cv f Z-1-0 7--
(Name of person acknowledging) (Name of person acknowled:y LUZ EDITH GIRALDO
MY COMMISSION#FF203458
�� p P« sf EXPIRES Mareh 22.2019
Zr;y•�•[,;j Fbndallota•yServ�c¢.corr
(Signature of Notary Publi -State of Florida) (Signature of Notary P ic-State of Florida)
Personally Known OR Produced Ident' is i Personally Known OR Produced Identification
Type of Identification Produc Type of Identification Produced
MY OM ISSION N FF140588
Commission No.Fr 1569 ;Aogdst25.2018 Commission No.1m (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS