HomeMy WebLinkAboutBUILDING PERMIT All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1— �Z�� Permit Number:
Building Permit Application
Planning and Development Services 1
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Per60 S1ll►
Address:
Legal Description: 1A
Property Tax iD#: f5� Lot No. O
Site Plan Name: `i6.o cpl L�Q� a S G Block No._ULL-
Project Name: 1? a StiP r
Setbacks Front Back: Right Side: Left Side:
_.me cct�gn"
Acl(litional work o be performea unaerthispermn—c ec all that apply,
_Mechanical _Gas Tank _Gas Piping _,Shutters —Windows/Doors
_Electric _Plumbing —Sprinklers _Generator &Roof tlk C
Total Sq. Ft of Construction: 10(k 0 Sq.Ft.of First Floor:
Cost of Construction:$ S�OG1D �y Utilities: —Sewer _Septic Building Height:
Name C Name: CS
Addr ss: 3 L' Company:_ o G "
City: �S •� �� �P� Stater Addre s
Zip Code: �1 C[Sv Fax: City: State,
Phone No. �� t {(��j Spr�°l Zip Coder
E-Mail: Phone No 77L 3 —t!S6
Fill in fee simple Title Holder on next page{if different E-Mail
from the Owner listed above) State or Co ty License c O 5'7
N value of construction is 2500 or more,a RECORDED Notice of Commencement is uired.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: 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
commencin work o�r recordin our Notice Of Commencemeent..
Signature of owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA ff/I
COUNTY OF J bu_/ ?i COUNTY OFF r LULL
The forgoing instrument was acknowledgg��SJbefore me The—forgoing in ent was acknowledg before me
this y of til 2d y thi> 1fay of �sL4
1 2�0�-. nby l
A s J�.41 cy�CiA 4 L4 Lkd VC�V cSUV
(N a of person ac owledging) (Na a of p so ack owledging)
nature of ary Public-State o lorida ) ( lure of No ry Public-Sta of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of identifications Type of identification
Produced JAIMEORTrz Produced —
'"" Notary=•ubhc Stott o; ; ^ JAIME ORTIZ
spires an ll .\t- Notary Commission No. 1h, - My Cpq> g , Commission No.�_�� Y'(�9i)Sta1e cr . ...
;ye 'ae Comm+ss+on A Ff 11 �. •? My Comm. Expires Jun 1 ?c.
Bonded Through Nat co „ ar Commission q FF 111465
- Bonded Through ationViolaw:--
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETAI`IO OVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. LA
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4388806 OR BOOK 4085 PAGE 680 , Recorded 01/09/2018 01 : 45 :43 PM
NOTICE OF COMMENCEMENT
Permit No. Property Tax ID 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 Description of property a d address if avail III
General description of improvements e
Owner/lessee
Address 10 04.&+ it �.�
Interest in property:
Fee Simple Title holder(If other than owner)
Address ems, L'
Contractor \{ T� Phone N
Address /� rC. Z/ Fax# 'rG_his ZLY�
Surety Phone#
Address Fax#
Amount of Bond
Leader 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 Stamen: /,�l A
Name / — Phone#
Address Fax#
In addition to hirmelr,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 THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER
PAYMENTS CINDER C11.713.13.F.S.,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WV YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
+
EN COMMENCMT. — f ^ftf. AtA& -.;Q�Z040
% a .,
�ner/I.ereee,amOwaer'e or Leeaft's4Kuthorizzd OMcwrDlrector/Parmer/Mmsaer/Slpamre
6 U"c
S+ Slgo."'e Tian ce
State of Florida,County of l�f� hMAPetr
Acknowledged before me this ,day of 20 by
w ItmillaH (mown to me or who has produced �l .L.��1 as Identification.
Sign'llture of Notary Type or PDio Name of Notary
STATE OF FLORIDA
Tide:Notary Public ST. LUCIE OTOtlNIDhion Number 71"• Sji, WAYNE LAR9EN
THIS IS TO CERTIFY THAT THIS I A ; f MY COMMISSIONaFFa8e8rJ
TRUE AND CORRECT COPY OF THE EKP REB
ORIGINAL . wrl ssecrss - JUM�'��
JOSEPH E. SM TH, CLERK " m"
By:
1D*puu11ty1Claar'k