HomeMy WebLinkAboutCray reroofAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division 1 1 1
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ✓
PERMIT APPLICATION FOR:
SED INPRO LOCATION:.
1
Address: 6L,,rce,
Legal Description: =Cim \o "1.Oc y✓ - /i y
a.11M110� �`w0 -
Property Tax ID #: 34ZS- 7d��tZ-Ol g �{ "DOO "Z Lot No.��
Site Plan Name: <o= „_'C' o,6zYo Block No. Is
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WMW
ST_RU_CT_ION INFORMATION:
tions workto a per Orme under this permit -check all that appy:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator%Roof 3 tt,1116 ch
Total Sq. Ft of Construction: I sreo Sq. Ft. of First Floor:
t
Cost of Construction: $ 5:4ep. 4W Utilities: —Sewer Septic Building He'
/ . S CONT ' CTOR.
Name S
l xt
W Name:
Address: �4
1 1
City: ST W QState:
_
Compan;
.ae_
Address: 1
City: State:I'—'L
Zip Code: 3tl4.9'Z�- Fax:
Phone No. Z%7�QZQ -' �6 b
Zip Code: Fa)?7li-z -o Krj
E -Mail:
Phone N,o- 7;? q 6-7
Fill in fee simple Title Holder on next page ( if different
E -Mail . 0.rWAN Z0610a
J
State orCou License 6ZWS73t%
from the Owner listed above)
i
If value of construction is 2500 or more, a RECORDED Notice of Commencement Is rtquired.
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Address:
Zip:
OWNER{ CONTRACTOR AFFHYVIT: 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 aythorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws orand cofenantsthat may restrict or prohibit such
structure. Please consult with your Home Owngrs Association and review your deed for any restrictions which may apply.
1 M �
In consideration of the granting of this` requested p*rmit, f do hereby agree that I will, in all respeds,•peTrform 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 cTwurre'tcy rei"w: room additions,
accessory structures, swimming pools, fences, wads, signs, screen rooms aart&accessoryuses tolanotliernon-residential use
WAkkING TO OWNER: Your failure to Record a Notice of Commencement may result in yottr 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
comrilencing work or recording our Notice of Commencement
Signa ure of Owner/ Lessee/Contractor as Agent for Owner
Sign of Contractor/License Holder
STATE OF FLORIDA ,..L
STATE OF FLORIDA
COUNTY OF �` �&ALI
COUNTY OF S+ Lyc1,.e
The forgoing instrument was acknowledge efore me
of �,'(AAL�
The foroing instr ment was acknowledge efore me
ISVI L %
this day 20�y
thisday of _ 20 %by
Rt"— 1�.GtS ,
Name ofM son making statement.
ibAu ni-
Name of pe on making statement.
Personally Knower- 4 OR Produced Identification
Personally Known OR Produced Identification
Type I entificat o
e of Identific n
Pro ce L
r uced �`°LDI
mom
(Si ure • PIor10s
• •
ignat P - a
•
Commissio I� N f
Esplm s�T2T.
Commitsbn #,GG"
Commi i; Mor `2tttt
20?i
t ,.{ 22
REVIEWS
FRONT
ZONIN&,
SUPERVISOR
PLANS
VEGETATION
SEA -TURTLE,
.MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DAE
RECEIVED
COMPLETED
Kev. a/L/v
i
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4445530 OR BOOK 4143 PAGE 1236, Recorded 06/11/2018 12:37:19 PM
Permit No.
State of Florida, County of St. Lade
KLMI 1-19mej WKImidm..aal ma
Property Tax IDNo. 3 Z,S-70Z-0lSMO-�e--
The Undersigned hereby gives notice that improvement WM be made to certain real property, and in accordance with
Chapter 713, Florida Stantes, the followtug Information Is provided in this Notice of COmmeocemeaL
Leo Description of property and address If available
General description of improvements
Address
lutertst In Property: d
Fee Simple Title holder (if other thin owner)
Address
Contractor
Address
Surety _
L�
Address Fax
Amount of Bond
Lender / V / l Phone #
,
Address
Fax #
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served
by Section 713.13 (a) 7., Florida Statues: A /� a
Name / T ` Phone #
Address
Fax #
Q
w
In addition to himself, owner designates ( V /-1 '
Phone # Fax # O U v, U
_
��� Z
to receive a copy of the Lienor'a Notice as provided in Section 713.13 (1) (b), Florida Statutes. 6xpdratba date of fto kl Q
commencement is one year from the date of recording unless a different date Is specified. WARNING TO OWN�BIY:�
ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPUTATION OF THE NOTICE OF COMME NCD(ENT ARE CONSIDERED MPROPBR
PAymENIS UNDER cH.713.13, F.S, AND CAN RESULT M YOUR PAYING TWICE FOR DAPROVEMENIS TO YOUR PROPERTY, A Nallat OF
CUMMENCLMKNT MUST BE ACCORDED ANDPOSTED ONT716 JOB SITC BEFORE THE FIRST IIVIEMON. IF YOU INTEND TO OBTAIN
PMANCMQ CONSULT W17H YOUR LEXIM OR AN A770IOI BEFORE COMMENCMO WORK OR RECORDING YOUR NOTICE OF
ccWIME iCMENT. A
WAYNE LARSEN S FFW4 '!
MV COMMISSION FFtNeB73 Owavll.wM • aer'r er Leawe'n Authorized Omra,71trea1ar?armaManaLa/Blpadn
EXPIRES Ju"05 2020 tLw.r
(aOTI ]9LJ�Sl rlonawaunr�n�.Nn p_.�T
State of FloAda, County of -1 W t"Qi
Acknowledged before me this 6 day of V I.'o 20 by
ho 4 personally known to me or who has produced ) as ticutification.
of Notary Type oVPrint Name of Notary (Seal)
Tole: Notary Public CommLdon Number
CM
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