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HomeMy WebLinkAboutBuilding Permit Application C SEP-14-2017 THU 11 50 AM CENTRAL SCHEDULING FAX No, 3212686138 P. 002/005 ALL APP B E�I MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l ,© I I Date: I�JJ Permit Number: rl/ I r-1 EIVE© ■ Building Permit Application SEP 1 2017 Planning and Development Services PERMITTING Building and Code Regulation bivision St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34992 Phone:(772)46Z-1553 Fax:(772)462-1579 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line�ePWAMV ...,-wu S .� r .r-r i :a;. ._ .�.,�.,-,•�,;• ..,�, .� I- i S n ur, ,s MIKE Address: Ce . Legal Description: Property Tax 1D##: _2_b1 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: r � e a r.. "t r ti al war to e e ormed under t is permit—-check a appy: HVAC Gas Tank Gas Piping OGenerator Shutters OWindows/Doors Electric Plumbing []Sprinklers QRaaf pitch Total Sq.Ft of Construction; S .Ft.of First Floor: Cost of Construction:$!n 0 OO UtilitlestSewer USeptic Building Height: Ei WIN Name L M1f' Name: Address Company: VI c City: ) C State. Add'�j�s: (1 Zip Code: 204551 Fax: City:YDY Qsr1 ' Pp- �1 7 Stater PhoneNo.�p Zip Code: E-Mail; Phone NO—JI`dV14 Fill In fee simple Title Holder on next page(if different E-Mail: ar Gil from the Owner listed above) State or County LI rise: ( 9 If vaiue of construction is$x500 or more,a RECORDED Notice of Commencement is required. SEP-14-2017 THU 11 : 51 AM CENTRAL SCHEDULING FAX No. 3212686138 P- 003/005 "�' 1.1 'd;'7A19;x'4'.�F� y P,4xs+tv:''cs r:l'Jrj�,s;"-.�h.^.•,'ri'in:•;FW. 4' Jr• rY' °3'."ye'...� x. ': i r {yrili'v �,'4 •'p't Ir d��f��h� � f.S. �'�r ah�1i� r. .N�,'F' 7"1 C G �AQ�yL': >'{� 5�.:�Il�:.l:l.�il�!'.LI, YV•7'.I' �:k1 _IY�, 'tl•y ;�:1��1a11-1-1�,.y., "���'11���r.;'ti� ^.�':r`:tN�3�FritS�Zwr�' 'G. �i��°•r:.?4 ::r,,:�4, Iryr!t3•�,rt4:. ...ln'!. .�. _ .,r;.,.. '..r)?. ,1.r ,. .J ,.. .,� , .,�• .ptc '.Y) '�1':tv.a.u7->,n'•;�r,:!.% �k'�ri S !�,r,t A! _,=F:q.,, •�tt�:•,;o'v [Vc.^Ailkr,.S�Tri��°:'s,!Li!l:l'.•i.. •*.�•:�$•q' -"`F'. ..f 7 ,,.ai�`1' �r Vii.:. .�'l' ,�. ,Y.0 ..kOf.��'.fY 4ir,»: tr}wI 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 AFF IDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. 1 certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie County with any applicable Home Owners Associamakes no representation that Is granting a ppermit Mll authorize the permit holder to build the subject structure which is in conflict tlon 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 ail 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 ofw er/ essee/Contractor as Agent for Owner Signature of Con aC r/License Holder STATE OF FOR DA -�1 STATE OF FLORIDA f COUNTY OF d COUNTY OF l/t lam/ The fo going instrumen was acknowledg before me The Bing inst ent Was acknowledgebefore me t ' day,of 20 ,by this day of J 20� by Name of perso making statement Name of person making statement Personally Known OR Produced Identification Personally Known L� OR Produced Identification Type of Identification Type of Identification Produced Produced {Signature of Notary Public-St;} or (Signature of Notary Public-Sta orlda Wkerine Konger Commission Nr Catherine Konger C on#FF172372 :G �on#fFF172372 Commission N G -�',�. �;OCT 2e,2018 o. s;p�28,Zp18 nONDEDTHRU ' PONnsDTkMU ixrnlu•� 75TFLORLDANOTARx LLO '�. •`W 15TFLORMNOTARY.LLC REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 SEP-14-2017 THU 11 : 51 AM CENTRAL SCHEDULING FAX No, 3212686138 P• 004/005 JOSEPH E. SMITHI CLERK OF THE CIRCUIT COURT -- SAINT LUCIE COUNTY FILE # 4348885 OR BOOK 4040 PAGE 1610, Recorded 09/14/2017 12:32:11 PM NOTICE OF CC�IJjtulNCEM,ENT SEP 14 2017 I, -- j Permit No. ZA7I Fo110 No __ PERMITTING - — - St. Lucie County, FL i• state of Florida Cqunty of St.Lucle j ha-undehloW hefeby gives notice that Improvementwill tae,pada to Certain real prope ty,and Ificeordanee With Chapter m,FJorlda Vatuter, .the fol(owfng'Informetfon is provrded'jn 4hls Nonce•o,►CornMenceineht, fon fP, y nd1}strt/[Q�Jtratidlrrd{/salf/{8�`V811�bI9�� y • •.1 1 �.'.T '•N 1 r Vf`-'.111.(' � � -rl :ti.1.w� Tr.��,•, �1.. vvs ..f•q:.r General dgw(ptlon of ImproveMen4 oWnerliito atlon or lessee) [ar altos if the t eSseQ sontractedlor the lmpravemetie. r 'Name Address triEei�stlq fn e „ `L tJailte an.{ari�ress of fee simple titleholder(If different from,'bwner listed above);- LL tti 5 > V 04 f;oniractarr6,Nafie; t ' I Cogtrectorliddre'ss tet,. 1 Dr , phone Niamber:� V $iiigty'(If appllsabfe,a copy of the payment bond 1s'attaebed):Amiiunf bf hand:$: __, a ,� dame end address: hpnA itumber;' a y Opw0 ' Lender Npni6: — -_ _ Phohe Number...- _ O p O Eender's:address; . 0 � OT)w Uj pe'rabnx within Slie Stator o�Florida 8eslgnated by OwfrGr upon whore naklses ar.orhe�documents Vinay be aeru,ed as proyFdedby3kc��i a ec ra AZrd3(x}�a}7:,Flnrlda'Statutes: y y ti-C-O Name:_' Phone NUrnlfeh - -— -- — . in:�dditFori:tdhipiseiforherse)f�flwnlyde�lgnstes_•.-_ .._ _ _- -_ _`of torecefveacopy atthe. Li enDA Notice as provided InSecflanJ"(1)(b);FlprldaStatutes,. "phohehum4er•of•pe>'.sanorentltydeslgnated:bypWner: ' Nplia 66 data ofnotlte of (the expitatl6h date may nat be bekrre'the completion of construttlo))and ffnpf paymAnt.to the CoHtrattdr,buttivilibe]'yearfromthedateofretordtn unlessa-differentdg� isspecttled) WARNINGTO OWNER.ANY PAYMENTS MAbt i�1WEgwm A�vt THE EKP(RATION OF TFI£NOTICE OF COMMENCEMENT rlRE OONSIDEtIER IMPROPER RA'(MENTS UNDER�11APTE$713,'PAItT1,.5£Ci f0y 719,13,FLQfiIDA STATUTES,AND CAN RgS11L7)hl y01jR FAY1NG,TYJICE Ff1jl: IMPROyEM�fM'TO'YOURPROPERTY:A NOTICE QP COMMENCEMtNTMUST 13E REWQ I)Efj AN6 Ir4STEb ON•14.1PO SITE flt:FQRE THE FIRST' IoECTIDN,IF YQV,'INTEND TO OBTAIN FINANt ING,CONSULTVV"YWR LENDER'ORAN ATTUANEY950.RE.COMMENCWG WORK OR 'RECORD.kgrAYOUR NOQCt 9F COMMENCEMENT. Upder penalty bf perjury,Lrjeclare that F have read the.foragaing napoo of corornaocament and that the facts stated thereln are irye to thg best of my knowledge end,belief. �'" .t ' Cather7rt13,Kptlg�r (slgniture of h r ortessee,or oviners nr Lessee's Authorized Officer/(hector/PartnerlMapag6r' Seo Qa4I FF17297Z EjwhTs;OCT x820113 13iFLDNROAGTAxLLC ,(Signatary'sTttle/Office), �., TheioregofngInstmtpefitwaiacckiowiedgedbefore methis l_,,/ day 0f ,.20L.1 • �Y � { r,n� ti I"`S11J_� as foe•,-,��; X.� Name of Person Type of authority(e.R.off(cer,trwtae)' 'Pad on be alf of whonJinstiurnient was pNecutWd' • persnnaliy knownor produced IdPntlflcatlbi (Slgnatura Ot,ry'"f"ublfc-State pt°floilda) ., (P0 Xrnp 0r-tmt3slone4 Nqb. of Notary Public) Type of laentlfleaii6n prbduced