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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB INF MU 7 BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I Permit Number: 1"CP a _ 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: Roof PROPOSED IMPROVEMENT.LOCATION: Address: 214 Beach Ave, Port St. Lucie FI. Legal Description: Sec: 22/Twn: 36S/Range 40E Property Tax ID#: 3419-501-0092-000-4 Lot No. Site Plan Name: Block No. Project Name: Dan Goller Setbacks Front Back: Right Side: Left Side: DETAILEDDESCRIPTION"OF WORK: �+ ByL i7 c CONSTRUCTION:INFORMATION: . Additional work toe nertormed under this permit—check all appy: HVAC 0 Gas Tank []Gas Piping _Shutters Windows/Doors ❑Electric ❑ Plumbing Sprinklers E]Generator W1 Roof flat Roof pitch Total Sq. Ft of Construction: 11Y dIX:7 S . Ft. of First Floor: Cost of Construction: $ 2,300.00 UtilitiesInSewer Septic Building Height: 9 ft. OWNERAESSEE CONTRACTOR: Name Daniel Goller Name: Gary Marzo Address:214 Beach Ave Company: Gary Marzo, Inc. City: Port Saint Lucie State:Fl_ Address: 861-A SW Lakehurst Drive Zip Code: Fax: City: Port St. Lucie State: FI. Phone No.574-292-8218 Zip Code: 34983 Fax: E-Mail: Phone No. 772-871-2489 Fill in fee simple Title Holder on next page (if different E-Mail: gmarzoinc@aol.com from the Owner listed above) State or County License: CC-C058193 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION- DESIGN ER/ENGI NEER: NFORMATION: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. 9__�O)fAL NA hw_ux � s Signatu of 0 n r/Lessee C nt actor as Agent for Owner Signat a of o tractor/Lictr older STATE OFF-0 IDA STATE OF FL RID r COUNTY OF o G,,leet COUNTY OF 1__tJG11 The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this Ja day of 20 .&Oby this ZZ day of 20 A�47by ham (Name of person acknowledging) (Name of p son acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known J OR Produced Identification Personally Known ,/ OR Produced Identification Type of Ident ," ,„ Type of I YP�.. DAVID VANDERFLIER _° DAVID VANDERFLIER '�' '' "`_ •? Commissi hN "= MY COMMISSION#FF a'[ Commission © MYCOMMISSIo (5q*99550 ". .............. EXPIRES March 9,2018 t '' EXPIRES March 9, 2018153 Flefidapiataryse-im"', Nom,, �` i Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE ILINITIALS