HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. 7i is—LO
Permit Number'
�—_ -T -
•
--- Building
Permit Application
Planning and
Dices
Building and Code Regulation Division
Code
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Per604 �
;L0,,,Ir
PROPOSED INAPVEMENT LOCATION:
Address: 7AZ
Luew„ Of 'LEtq Sz
Legal Description:
(1q Z �rj
Property Tax ID k: —+ Z� —+
Will
Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side:
Left Side:
NOF WORK:
6 i
L
O� TRUCT f.'
AtltlltiOnal work to be performed under this permit — check
all that appy:
_Mechanical _Gas Tank _Gas Piping
Shutters Windows/Doors
_Electric _Plumbing —Sprinklers
_Generator Roof 3 WtIZAitch
(
Total Sq. Ft of Construction: 60l) Sq. Ft. of First Floor:
Cost of Construction: $ 46eg:Wem Utilities:
_Sewer �Se� Building Height: f
ER
RA
Name
Name:
Addr ss: 7�
Company: �o
:...
City: State:
Addres :
Zip Code:�iRVZ� Fax:
_
City: Stater :
Phone No. " % �
Zip Code fag Fax�%17 �=03cf'?y
E-Mail:
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or Co my Licenseg:�!!s 7 g
lb
If value of construction is 2500 or more, a RECORDED Notice of Commencement is quired.
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Applicable
Name:
_o
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: .JCn–Wot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR'AFFIDV'IT: 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 Counttyy makes no representation that it granting a permit will authori - he permit holderto build the subject structure
which is in cpnRict with any, applicable Home'own�rs Aoodttion rules, bylaws -rand covenagts tat may that may. prohibit such
structure. Please consult with your Home Owners Association andreview your deed for any restrictions whicp May apply.
In consideration ofthe grInting df this requested permit, i do herebyagree than 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 LLndergoing a full con curfenty reyievv�� room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms a+id adcessory uses to ahoth2rnDn-residential use
WARNING TO OWNER: Your failure to Record a Notice gf 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
cornmencirly, work or recording our Notice of Commencement.
jzt__—�5K .. ===== —
Sig— na u e of Owner/ Lessee/Contractor as Agent for Owner
z
Signatur&df Contractor/License Ho e
STATE OF FLORIDq G�'
COUNTY F S
STATE OF FLORI /
W :
COUNTY OF .--- fir• r
The forgoing instr t was acknowled a before me
this,of 21by
The for Ding ins m t was acknowI dg efore me
this day o
2V�by
Name of 04son makin atement.
Name oflakson makings tement.
Personally Known - OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced --.,_Produced
•`",,• JAIME ORTIZ
..'
nature'o' Nota r r to dl4lli4j NMI onc"—
(Si N pf bnc `j
. • M>r teirtwt. Ef11N�; fan 1. zo a
lib - store or Fiar c
Commission No.. ' Fff1w8E
Mr CommE Hi Jim 1. 20:1 E
Commission No: ie FF 1T1485 r
� ,. �,' _ OAaI NUaru As_
.`•Com
. ,�'---6grld1Y01MtN�Y9W Nutty Assn.
REVIEWS
FRONT
ZONING
$UPERVISOR
PLANS
VEGETATION
SEATURTI,1E, ,'
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
.:DATE
RECEIVED
a'
'
DATE
COMPLETED
ev.
F
IL L
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 4401982 OR BOOK 4098 PAGE 399, Recorded 02/15/2018 01:34:08 PM
Permit No,
State of Florida, County of St. Lucie
NOTICE OF COMMENCEMENT
Property Tax ID No. Z"0:--b—CM'9
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 and
General description
Address
Interest in property:
Fee Simple Title holder (If other than owner)
Address
Contractor
Address 1%
Phone# M-9357—f.CZZm,
Fax # 771-3AS-03 1
Surety /_V /T Phone #
Address Fax #
Amount of Bond
Lender Phone#
Address Fax #
Persons within the State of Florida designated by Owoer upon whom notices or other documents may be served as provided
p < tr
Sjc1tb%Q7".13 (a) 7., Florida Statues: AQ �
m y�e>`1Phone#
dteq n O Fax #
m-00
o MIn addM ,U himself, owner designates 1 of
O
{.� A i Phone # Fax #
i to xecte dopy of the Llenor's Notice as provided in Section 713.13 (1) (b), Florida Statutes. Expiration date of notice of
cot)yt�ggcement Is one year from the date of recording unless a different date Is specified. WARNING TO OWNER:
= ANOPR1'MENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER
PA i in t s UNDER CH.711.13, F.S., AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
A CCQ?dNCEMIr
MENTUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. iFYOUrENDTOOBTAIN
FW"gING, CONSULT WrrH Y UR NDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
CC"ENCMENT. � kIi�12046
. cls /
X //LNa
.' Ovner/Lenee, or Owen's or Leuee', AuthdHzed Oflim/Dirertor/Partner/Manager/ Signature
�:, dceNEf
Signatory's TMe/Omee
State of Florida, County of STt
Aclmowledged before use this 7_7. , day of20t, by r e
wT is personally own to me or who has produced 4M f1—� !DLA s identification.
SI afire o otary Typ' a rrQ( Nan Lk WAYNE TARSEN )
Title: Notary Public Commission Number ^- MY COMMISSION a FF9W,73
4, EXF4RES Aura 05, 2020
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