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Home My WebLink AboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 0 V'OC• ��Y i ...{,..ii}4ie'i'::ii•::..,.M..ii.,:...,?:.Jii'}i}ij-Sy}ffffi •.ffi=•;.i iv.i.. t.s ..r . I RECEIVED Building Permit Application ,I :FEB 21 7018 Planning and Development Services Building and Code Regulation Division Pelli tting Department SK.Lucie County 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial v#*'O' j Residential a PERMIT APPLICATION FOR: To Select from dropbox, click arrow atPe end of line -.}}.-..:.:l:iii iiis�::�::iiiiiiiii?iiiiiii':i::;':iii,:"i;::}:.w:•::::::::v;}::?::::..:::::::::::::::.v: w::.v:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::nv::::.v:m::::::::::::•:::::w::;:m::::::::::::::::::::::::::.v:•:�v::::m:::::.u:::x::.:::::::w:x:m::::::::.:::::::::::::::::::•..?::nv::::::::::::::::.::. :..::....................................... Address:0GjAv%. jSA4 ✓et,Ld%3 &,ukp ....u.iu,.. 100 S ,6C1Aw,, 02.. 1Gn -ei^ 6CA42"T,PL. 34-911-1 Legal Description: SC-0- AA,,�Wczp Z..& ( i_% _� is cra•hova, ead-CAL 31Aa. - 96,•31 - 0001 - 100000 Property Tax ID#: 3J-ol a, - 9631 DOCS 1 - U OD 1!!k Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side., i, Io .:....... ..:...:..:::..::....::..:.:....:.....:...:::...:..:..:..:..:.:..:...........:..:....::...:....:.........:.:.::...::. .....:..::.:. ?::........:::..::::.:.....::.::.}.i.:::}}:.}.i:::.::;::'::::.::i':i::i:.:iii::i<:: •isi'ii•:ii:.if•:;•}:;•}:•}:•}:•}:•}:;•:•}}}?:.}:{•:i•}}}}}:i4;•}:•?:•}:f'.}:�}}}}}:�}::;•}::.:}'i::.}w:::it v: :r[:::::::::::::::i::::::.v.v::i::{:::::i:.v: 4.....t.............................. �}s :vSi' {<i i- i'}iii' :' ii ^i>:ii...ii:....... .....:{:ii};:ii.:•}}.ry.. .....................................:::: :: : : .•' is .•'i ��:•?•• •' �.��•i i:�.it•i•:�v:'i�.<:i::}.:.; iiiii:i�i:�iii�:+�i:i�iii:iiiiiii:•':�iiiiiv... ............... ...... .........t.w:::::::::::•}'•:t. .....................................:......:::y::::.::v?.ttvi}:•:w:.w::::::::::w::::::::::::•v::�:�:�v::.v::::::::::::.:::::•::v::w::::::: ..........t.t t...t t..... n...............v...v.v t�::w::::::::::{4}:i•}}}}:i•}:i•}}}};>};-}}:iiiv}}:}}:-}'.}?i;}?:•}}i:v:}v:v:v.v:w::.v•:,.y...:.w:::::::::::w:::: :::::::...vr..... .tti....t.t ..i..a.t.............:. 1.4..1......1 41.11.. �:::::}:::::}r:r:•i}::h^.. .}:nt:::.v:::.v:::.vn>rt.......................::::::::::::::::::::::::::::::.v:: ..t. ':' :}:::::::::::}..:..:}:.1.............n......n:.v::::::::;} w:::::::.v::r:ym:}:.v?:J:•}}:Ji:v}?}:itii4}}}}};.}•}::.:::ir:::::::::::n:-.}':::•y;:}:::::.::::::::::::: Poo(, I`EucT ABuAc•44- SO 16(v K_ Hvic,.4.-.c.IMk® &,4rb S c.C. SPR 1�tk�" PI) CA j�nc�C Sa 1 a.�� o .iii.}':iii.}' w.......1t........1.111.. ,.:.}.:.?•..•i.>::.>:;.::.:::::.::;:;.}:.}.:<:<.}:.}:.}:i.}}:.}:.}:.}:.}:.}: '.::.::i.::.::::.::. ::::::::..::::::::::::::::.�:::::::::::::::::::::::::.::::::::::::::}:.:::::.:}}:.::}::.}}:.}}•.}:.}}:.}::<.}}}:.}:. :ii:X...... :.....:...................................:....................:............ ...r:..,::...:........:r...r.....v............................:.........::...:.rr:::r::.,::::::.vv::: Additional wor to be Dertormed under this permit-check all that appy: ❑HVAC Gas Tank ❑Gas Piping Shutters ❑Windows/Doors ❑Electric ❑Plumbing Sprinklers ❑Generator ❑ Roof Roof pitch Total Sq.'Ft of Construction: S . Ft.of First Floor: i Cost of Construction:$ 9SI0 - SO Utilities: _Sewer❑Si ptic Building Height: :<:Yiiii.,:..ui ta•:iiitt:•4i}}kx•}?}}:.}i?}}}}}}.'•:>;.>:iii:.}:.?}}}:.}:;;.:. :: i:.:�j"Y•'�. i .�tR'!• }::::h.:}::.y::::::.::::::::::::::::.v:::::.::v:.v.........v.............................4:: :.:: C�i}'n."�:i.`��!lj�. :..}....}..4+..}.... ...4.. .. �.IMf.. .. ��.�.. lM.�'�[............n....................................:.........................................��.�`..f�'.�. �:•\�:>.:::::iv:i::i vii:•:>�i:is>.>......v.......t....:v....:..:::::::::::.tv:.::::::::::\:::.:.:r:::..::: ...::;:.:::..,;:.:.:,v,v..:::::;}::i::::::.::.:}}::}:::::w;:}}:::}::::::::}i}iii};}}}}::4;}}:•}}}.;-}}iv:{::.}:•}}}}F.}:L:=i:n:-:.:.}:.•{.:v.:.}:::.}}:'i•}:•.}}}}}}}}:{•}}}::.}}}}}'.}}}}}}}}v.}}}}}}}}:}}:?}}} iiv.•{::.:;.•.:i}}:}}}}}}}}'::.}:i•}'.}::.}}}}}}::.:i:.}:-}:::.}}}'.}}}:::^}}}}}}}i{{. Name_6ceA-A_. Lim thc�,s CA!nA Assoc', Name: Te2A4F I/e,,�•rcw Address:/DO S _ oGf kr` on— Company: Poo c City:;t,�s e-,-- A e'tc4-t State: Address:17&'1 Ke, Zip Code:3` 1.S-j Fax: City:j%,Inj IS C,-,444 Stater. Phone No. 7 ? oZX9 I r1 o-IZip Code:-1`(yS�l Fax: 77,1,33-(-/796 E-Mail:oe_c,". 1Sd4 Phone No. 7 7 61, Fill in fee simple Title Holder on next page(if different E-Mail:- 1 -Mail: �i from the Owner listed above) State or County License:' G: I`(S-t L 3 If value of constructiomis$2500 or more,a RECORDED Notice of Commencement is required. � I I I xA"f:'r }}?.}•.}'...:::::.:}'::}}:iii:is.i?':.....::;/:,;.....:.......:.:...:.::. :...:...:..::::.:.•::.....v:::.:::,...,.,:•�.:v:.}.v':'.v•:.:-.v?v.}::>:.:}.}}::R::M:...i..i:•..:.':.}.:?}v::::•i'..}?}:}::j,F:'�;:-.[1;:►::..i'•"?:':::}}:}::.:;:.:•..-:::.•...:....:^..:.:.::+.-.;�.v.'.ti'�.+.'.::.ti:.?..4.'}}.•::...}}:.}.:.:::�:..'.:}.:..::.��.'..:.:�.::{.tii:�.'S:.:v}::.iYi.:vi:.}:::.i?'v:.s:}i:.::}si.L•}:..::�}ii.}:i:.::ii:?.:s:i.:ii:?.:?:'.i$.s:.•i:v}i.i}i:.::::{:.:`vi.:.}:.i?!:}.:�}i:.?}}:.tiii.ti':ti:w.:•.:::i:t.}:siv.L::.::}:i.?:::r: 4:i::{::�:i})}:::ti?.}.:i:•.:}••j::.}i..::.-i•v::.v.i:iM ? aR ':Ni+:i^::}:.v::}?i.:'>•:{.:::.}�}::i::::i)�:r::::k?�ti::::i:?:::}r:$::•i?'vv•i•::}i::::•ij.P':ii:}::L:ii:}:ti:•}:::�:}i::}i:::}i:::::^::ii:}::::S:ti?::::i:!:i:iv::bv::::i:.C�v:C:vi:::i:.,tiw}i}?h}::::}ii:}i::::iSvih•':ti.•:�?iv:.:•:.: :•}.................v.......... DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: I State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: IJ City: City: .I Zip: Phone: Zip: Phl ne: 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 theper lit 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 a;i y 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. i 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 ar an attorney before commencing work or recording our Notice of Commencement. I� ure Owner/Lessee Contractor as Agent for Owner Signature of ontra for/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF 1I ��1'N The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this� y of�� .20 y this day of 20J& by C V/pAd Name of person making statement N amd of person making statement (Personally Known Pr dV %011 f i Perso ally Known OR Produced Identification Type of Identification Type f Identific ion ��'fAg Notary Public State of Florida �I� ` �; - Produced is Barron Produ d C My Commission GG 152930 �r Marianella Campagn i„a Expires 10/18/20216 . �i+ State of Florida 0SOPY rnmmission No-GG 1My Commission Expires 140 021 55 (Signature of Notary Public-State of Florida} (Signa r f to I Public-State of Florida) I I r Commission No.Q<2>l�� (Seal) Comm sion No. b S (Seal) �I I REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION- SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIIIEW REVIEW REVIEW DATE RECEIVED DATE i COMPLETED II Rev.8/2/17 I I I I