HomeMy WebLinkAboutBUILDING PERMIT All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: r 7/ y Permit Number:
10 Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34992
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _X
PERMIT APPLICATION FOR: � 1
Address:
Legal Description��` e Uh
Property Tax ID#: �OQO—46 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
1
AOdItional work o be pertormed uncter this permit—check all thatapply:
_Mechanical _Gas Tank _Gas Piping _Shutters -Windows/Doors
_Electric _Plumbing _Sprinklers _Generator Roof
�t�I I�,
Total Sq. Ft of Construction: k-C(d Sq. Ft. of First Floor: P
Cost of Construction:$ d,Obd ,e5i�p Utilities: —Sewer —Septic Building Height: kfo —
Name Name:
Address: n*rCompany: �.
City: ( _State:T[� Address: .16
Zip Code:.4Q QJ fix: City:ye _Stater
Phone No._71-'Z"' _ 60 Zip Code: 34a9Z Fax:? —
E-Mail: Phone No
Fill in fee simple Title Holder on next page(If different E-Mail-trS\11.1 eQ enL tl
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Curnmencemek Is required.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: >5;:-:'9ot Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: of 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
c mmencin work or recordingour Notice of Commencement.
� I I , U_10r'.4 —
Sig ure of owner/Lessee/Agent Signature of Contractor/Ucense Holder
STATE Of FLORIDA_ 1 - STATE OF GCS COUNTY OF FLORIDA L U
COUNTY OF ' W
The ff�rgoing instrument was acknowledg d before me The forgoing in rument was acknowled before me
this day of 20by thu1 d' ay of 20g by
1 I D ' �Ci',�—t LJ 'A J-4 LAY - 1 _GVYLCI
(Name of pe so nowledging) (Name%6fcperso acknowledging)
(Si ature Notary Public-State—&Florida) (Si lic-Stat6ofYlorida)
Personally Known\`�_�- , WJt2d��- Personally Known OR Pre, p �ypl'91htit;,((RT12
Type of Identification a:'PLa•., jA1M r— Type of Identification °�I°c-Fa e n 5,,i
;'��, ;�, Notary Puhlic State of Florid: Produced `� ,% PAp Comm. Expires Jun 1.201°
Produced °C ommission ak FF 111485
��yy++ 20�2 ((11 q ,.
Commission NQ.�' 1 `�, ; C mi Sion N FF 1114g5 Commission No.Ti'6 1°ice AFkhorW Notary Assn
goad flh National Notary AS'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.7/2014
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 4386805 OR BOOK 4085 PAGE 679 , Recorded 01/09/2018 01 : 45 : 43 PM
NOTICE OF COMMENCEMENT
Permit No. Property Tax TD No.
State of Florida,County of St.Lucie
The Undersigned hereby gives notice that Improvement will be made to certain real property,and in accordance with
Chapter 713,Florida Statutes,the following information Is provided in this Notice of Commencement.
Legal Descri lion of property and address it available
Gmeral des npt(un of im rovements
Owner/tenet �G
Address
Interest in properly:
Fee Simple Title holder(if other than owner)
Address L
Contractor S Phone#y-7?I/7+ ��-1S6�2
Address Alwo
... Fax# • iG�33�0�f{�
Surety /d. Phone o
Address Fax#
Amount of Bond
Ay A-
Lender ��� Phone#
Address Fax#
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(a)7.,Florida Statues: ��JJ
Name f{ Phone#
Address Fax#
In addition to himself,owner designates of
Phone# Fax#
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. Expiration date of notice of
commencement Is one year from the date of recording unless a different date is specified. WARNING TO OWNER:
ANY PAYMENTS MADE BY'I HE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER
PAYMENTS UNDER CU.713.13,F.S..AND CAN RESLIT IN YOUR PAYLNU TWICE FOR IMPROVEMENTS TO YOLK PROPERT Y. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE TIE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH Y UR LENDER OR AN ATTORNEY BEFORE COMMT•NCWG WORK OR RECORDING YOUR NOTICE OF
COMMENCMENT. 01?;V, VA*M �;Pj2VO
Owoer/Lesarq or Owaer's or Lessees olborized OmeedDfrectar?xrinerMaaayer!Slpubr<
Qf1Aai�
SlEeatory'a TitldOmce oo State of Florida,County of Y GO �/�'�//�T1rLr'��
Acknowledged before me this Z ,da of 20 b
wh is personally(mown to me or who has produced D04,t if IL li ` as Identification.
SI core of Nota I I)A tine L a CU A )
ry STATE OF FLORIDA YR Notary (See)
j ST. LUCIE COUNTY
Title:Notary Public THIS IS felILROORNM
TRUE AND CORRECT COPY OF T*HEB : WAYPIE L:,t3EN
ORIGINAL . MY COMM1581ONaPF11B{573
JOSEPH E. SMITH, RKExPiRtS.,„Ia 1M,2020
.or Ll-0�q names,,,
i By:
Dap ly Clelk
note'. ► �Iig