HomeMy WebLinkAboutbuilding permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
-_J I J ' _ _
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division 1
2300 Virginia Avenue, Fort Pierce FL 34982 'Y�p
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: S4•k , �
PROPOSED/INPROVEMENT LOCATION:
Address: V64Ie zet., 3
Legal Description: l,eS o
Property Tax I D#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be pertormed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_Electric _ Plumbing _Sprinklers _Generator XRoof L44tch
Total Sq. Ft of Construction: (Z7-7i Sq. Ft. of First Floor:
1
Cost of Construction: $ �j� 06,& 4 Df, Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: Mc
Address: Zk Company: e
City: State: Address: �t7
Zip Code: w� lA / ,Fax:/ City: Stater
Phone No. 77a-'�lbl�-(��tZ.N Zip Code:3t{c�, Fax:m'335�'d�
E-Mail: Phone No
Fill in fee simple Title Holder on next page ( if different E-Mail w dt S , Q_ non-
from
the Owner listed above) tat or Co my License 0-49;-731
If value of construction is 2500 or more,a RECORDED Notice of Commencement il required.
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DESIGNE ENGINEER: Not Applicable MORTGAGE COMPANY: of Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: of Applicable BONDING COMPANY: )CNot 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 pp,ermit 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 w th 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
commencing work or recording our Notice of Commencement.
(�r A . �
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Signatu+'LrMUwner(lessee ontractor as Agent for Owner Signature of Contractor(License Holder
STATE OF FLORID STATE OF FLORRLA
COUNTY OF �� Gal COUNTY OF ST—W
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The g instrume was acknowledge efore me The forgoing instrument was acknowledged before me
thi y of + _ 20� this day of 20� 6y
u y V-A-- L-Gv -�-Ce ,
OfnaA l
( me f person ackno dging) (N a person acknowledgin
( ' t re of Nota lic-Stat o rida ) / (Signa re o No ary P 1 - to of Flori )
Personally Known OR Produced Identification v Personally Known
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Type of Identificat' Type of(dent ' Lion ' ANNEMARIE SINGER
Produced ,r, duced Notary Public State of Florlda
ANNEMARIE SINGER �^ ors Commlasiart♦GG 08581ia
_ �Peblic-Slate of Act C mission NO V D - 1 . My C�l+pires Mar 22.2021
Commission No '`( o Ibsibn i GG 0"a I
' �»hN. J Comm.Expires Mar 22.2 21
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
JOSEP:1 E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4428535 OR BOOK 4124 PAGE 2594 , Recorded 04/26/2018 10 :58 :11 AM
NOTICE OF COMMENCEMENT
Permit No. Property Tax ID No..3y,O -OIW A-OQ0-q
Stv to of Florida,County of St.Lucie
Tbr Cudcnlgned hereby gives notice that improvement will be made to certain real property,and in accordance with
Chapter 713,Florida Statutes,the following information it provided In this Notice of Commencement.
Lecvl 1) scrlption of property and address if available
-t.�V= 3Na -7, r al
Genrral description of Improvements SakE
Ov,,crlersee
Ad,:,r.. `L
Ina rest In property: "�A^
Fvr Simple Title holder(If other than owner).. A2 TC .
Address
C' irartar Phone# 777�-!�_12-Y
Ad. .css Fax#
Sur.1cAL Phone#
AC „ Fax#
Ai ;,I of Bond
Ler._',r Phone#
Ad. .ss Fax#
Pei ,jus within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
b, - I-,a 713.13(a)7.,Florida Statues:
Nw '• A/\ Phone#
A,I '-„s Fax#
In 'hlon to himself,owner designates /01
- of
_. Phone# Fax#
to, ',e a copy of the Lienor's Notice as provided In Section 713.13(1)(b),Florida Statutes. Expiration date of notice of
v, ncement h one year from the date of recording unless a different date Is specified. WARNING TO OWNER:
A:. .�Y.MEN S MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER
P f[ TS UNDER C11.713.13,F.S..AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
Uf 1Iv'CEMENTMUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN
F1 -i,NG, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
Co \CMENT.
salLeueq or Owner's or LmefirAuthorized Officer/D4r:tor/Puarr/MaKal Slisaam
A
fJ Silos 's TiBdofrl .
S• . f Florida,County of �W • QL _ ��f '
Ac ,,..ledged before me this day of�a _20 by 4L/ I,f �Y'tAyt,
v, , i. persooatly known to me or who hu produced as Identification.
It
of o TA A Ty a or alint Name of Notary (Seal)
ST. LUCIE COUNTY
TIC "11tary Pubtl HIS IS TO C �L I�M._lP
RUE AND CEAI O{rl"YYF`T : ; WAYNE LARSEN
ORIGINAL . �, f Si. M'COMMISSION#FF984673
JOSEPH E. SMITH, CLERK cf �;� EXPPIIRE Juno 05,2p20
By:_)t,-AaoutYcl.a a
Dote:��1 ` n