HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/27/2016 Permit Number:
s, fs. RECEIVED SE.' 7.06
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: Window/door 'mor
PRO .0$ED IMPROVEMENT LOCATION
Address: 170 NE FLORESTA DR, Port St Lucie, FL 34983
Legal Description: RIVER PARK-UNIT 9-PART C BLK 81 LOT 2 (MAP 34/21 S) (OR 3455-2575)
Property Tax ID#: 3419-570-0100-000-8 Lot No.
Site Plan Name: Block No.
Project Name: Side Door
Setbacks Front Back: Right Side: Left Side:
.a t y
LED DESCRIPT
DETAIION OF WORK
a
Install external door �/ odor
CQNSTRUCTION INFORMATION
Additional work to e—e orme under this permit–check a _app y:
HVAC 11 Gas Tank E:]Gas Piping Shutters Windows/Doors
❑
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 1580 SFt. of First Floor: 1580
Cost of Construction:$ 450.00 Utilities:n Sewer Septic Building Height:
OWNER/LESSEE CONTRACTOR:.
Name Ramano Lopez Name: Roderick Waller
Address:170 NE FLORESTA DR, Company: Sunrise City CHDO
City: Port St Lucie, State:FL Address: 3550 Okeechobee Rd
Zip Code: 34983 Fax: City: Fort Pierce State.FL
Phone No. Zip Code: 34947 Fax: 772-907-0420
E-Mail: Phone No. 772-201-2850
Fill in fee simple Title Holder on next page(if different E-Mail: rodwallerl @gmail.com
from the Owner listed above) State or County License:
ZGC )STS-1
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN rLAW INFORIVIATIONa
. :
,.
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.
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_Signature of Ow r/Lessee/Agent Signature of Co ractor/License Holder
STATE OF FLORIDA STATE OF FLO-IDA �Uc
COUNTY OF S y
Lcl� COUNTY OF_ -5*}>
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thislaa_day of 5-ot P-7 20 �Gby thisa.1 day of 20 \�_by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Publi -State of Florida) (Signature of Notary Public State of Florida)
Personally Known OR Pro uce i Personally Known OR Produced II
Type of Identification Produced AGGA Type of Identification Produc WASG
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Commission No. {GQ\� Ip„b��oVPde Commission No. G� SSS`O� Us+ 2r
Revised 07/15/20
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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