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HomeMy WebLinkAboutBuilding Permit Application SEP-14-2017 THU 07:37 AM CENTRAL SCHEDULING FAX No. 3212686138 P- 002 ALL APP LE I ,MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date; !� Permit Number: �y 1 1 0 I RECEIVED Building Permit Application e, Planning and DevelopmentServices SErp 14 2017 Building.and Code Regulation Division PE MIING 2300 Virginia Avenue,Fort Pierce FL 34982 IT t.Lucie ounty, FL Phone:(772)4U-1553 Fax!(772)462-1578 Commercial Residenf PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line �,iS �%4.' ..i-i•3i•���.. �i;¢�l:;,y. �r°. "P .�•F't:sd,.:{�i,r:•�.';"!`�..¢.{a,.,,�r'�. .r Ce a:4e k•. ...r.a�•"�i�b,.. ,;elf:•. �: �;�:M.'�',-...,;:;.p.. :a --.}•'fr.li��.•a..�' .,e:`im ..r.•,tvJ'+... ;�fOPQSEa;�.�MPR�dV� •:�•.''C�LO;CATIO,N.,,;,::: �:�� {:.,.,.�::F: :.t i', ,.,,� Address: Legal Description: 3y I H �o1 110a Property Tax ID#: Lot No. Site Plan Name; Block No. Project Name: Setbacks Front Back: Right Side: Left Side: .nF.;• r.;{f4 a os ;ta•Rfn1S,'t" ..Wa.. �t.rtis�"A ,'Y';'>.a;ao' •aqi r�'• Jai„^_ :,.� y{{, ,yr tx .u� r :S,P!4C'!D).�,: ;,' a t,. rl a ' Saw; ,�'f,.1 y, �. '° j' �; i �, •d� :�. �, '!� .f p 4' •.ljrR f{ 1- a a.,'n'xl j:e• rA.� fy 7 :irS�liN3:7SNS"�3flt"'E:E;e�:in �•k?!V'f 4V..'1`'�i ,�d':�.L��?f�� �r :.✓�t{��,-{,�,.'�IU.,`^'o- 1 1'f ei"r:sd`q'�'d^1`�.;�. 9 �ye ?1� '�'' '+ � �_i y,� "��.��,� '1`.`Tse -eu+,ce:y:iy U�FtIK"�d{'J• et q�( K ��. � ,r{:. i lona wor to a er orme un ert is permit—c ec a appy: ❑HVAC Cas Tank ❑Gas Piping _Shutters ❑Windows/Doors 11 Electric 0 Plumbing Sprinklers Generator 0 Roof Roof pitch Total Sq. Ft of Construction: S .Ft.of First Floor: Cost of Construction:$_ f7��. Utilities:�Sewer©Septic Bullding Height: .�. .. c 1 1.isa'^"� �, .�„,c„; �.:.7y,;cw�•n: ..ryr• •r. .Y, I•,• �.,:y: ,.r. •.�,�.' �, •,., ;• ,l i 1 ''p d•. /, �' a �tlt.• •r i'V � d.Pk L •�: Name. Name: ( �P_ AddreCal' Company: City: �.f,LG State: Addr s: Zip Code: 0 L Fax: City. iI C State: Phone No�12, Zip Cod Fax..'rz, E-Mail: Phone No. z -.- Fill In fee simple Title Holder on next page(if different E-Mall:C e,'� L Qi - COM from the Owner listed above) State or County License: C- C If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required. SEP-14-2017 THU 07:31 AM CENTRAL SCHEDULING FAX No, 3212686138 P- 003 �. !'P''%t'S:7M1.y:S:,. <., : ..r,t .�ax.14';, .Yac,•. • Sl1A'P' fVl co ,CT :LjN:' iVT 0 a, � 1�41n iNi+ ItIiMATiOi�: ,,;;°::• 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 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. Signa ure of Owner/lessee/Contractor as Agent for Owner Signature oftoractor/Lfcense Holder STATE OF FLORIDAQI STATE 01=FLORIDA COUNTY OF V ' COUNTY OF \. �l�•. The forgoing Inst r ent was acknowledged before me The f�r ping Inst r ant was acknowled afore me g th day of 20n by this da of.up.• 20� by Name ofs 'n ma atement Name of er on ma g tement Personal) KnownPoduced Identification Personally Known ducd identification Type of Identification r� ,�''� Catherine Konger Type of identification # ' atnerine Longer 3f;:Commission#FF172372 Produced =f` aY,iS.^Covtmiss101OFF172372 Produced xg res:OCT 28,2018 r^' res;OCP 28,2018 BONARDTHRU ^'r e��� 1ST p60ND Oj'AR �iu,�u• IST FLU RIDANOTARY,MC XLLC (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Commission No. (Seal) Commission-No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE• COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE CQMPCETED Rev.8/2/17