HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I/ Permit Number:
1 J1 _-
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential V/
PERMIT APPLICATION FOR:
PROPOSED INPROVEMENT LOCATION:
Address: t{ TFDf� ►2IL'O� 3 Z
Legal Description: Q\k—w J Z
—9
Property Tax ID k: Lot No.��
Site Plan Name: ���� rAl�� Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
D
CONSTRUCTION INFORMATION:
Additional work to be pertormed under this permit –check all that appy:
_Mechanical —Gas Tank _Gas Piping _Shutters —Windows/Doors
_Electric —Plumbing _Sprinklers _Generator Roof % n &itch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
I
Cost of Construction: $ %, 06Or00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name S
Name: W
_` `-
Address: y3\ P4U�OTts t.c�AQ_
Company:\
City: nC "� e 'e CAP_ State: EL
Address: 1 of Agki
City: State
Zip Code:ZtlgSZ— Fax:
PhoneNo.77Z^4/a6-(2tdZ�,
Zip Code: Fax: Z–
E -Mail:
Phone No .. S
Fill in fee simple Title Holder on next page (if different
E -Mail ,
from the Owner listed above)
State or Cou ty Llcense66 7
If value of construction is 2500 or more, a RECORDED Notice of Commencement is rebuired.
DESIGNER ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
COUNTY OF &-e—,
Address:
The fo ng instrument was acknowledge efore me
this of QUAD 20 by
City:
ZjP: Phone
State:
City:
Zap: -Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:Not
Name:
Address:
Applicable
Address: -
City:
City:
Zip: Phone:
4ignat }
Po arioaCOmm15510
Zip: Phone:
GG"*�ycMor `2071
uwiVEK/ CUM r KAAL ITAr•FIUVIT* 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 priorto the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will aythorize the permit holderto:build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws orand cedenant.%that may restrictor prohibit such
structure. Please consult with your Fume Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested ptrmit,'r 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 undergoin&a full concurrency review: room additions,
accessorystructures, swimming pools, fences, wags, signs, screen rooms aand'accessori uses to -another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in yolk 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
comnlencing work or recording our Notice of Commencement
Signa ure of Owner/ Lessee/contractor as Agent for Owner
Signa a of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF &-e—,
COUNTY OF `% LtIL�
The fo ng instrument was acknowledge efore me
this of QUAD 20 by
The fp 01- g instr ment was acknowledged efore me
,day
this'LS day of20�y
7�+
Name of son making statement.
'A+llJtJJt0g -
Name of pe on making statement.
Personally Knewn <'. OR Produced Identification -Sel—
Personally Known OR Produced Identification
Type 1 entificat'
Pro ce p�
u� -,
OAz
(Si ure o o Florka
4ignat }
Po arioaCOmm15510
rl:rCOnpnllfionA
GG"*�ycMor `2071
22
a
REVIEWS
FRONT
ZONING.. '
SUPERVISOR
PLANS
VEGETATION
SEA -TURTLE, i
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DA f ,
RECEIVED
'
DATE
COMPLETED
_
Kev. �i�r
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 4448691 OR BOOK 4146 PAGE 2514, Recorded 06/19/2018 02:36:58 PM
Permit No.
State of Florida, County of St. Lade
Property Tax m No.
The Undersigned hereby gives notice that Improvement wW be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following Information L provided in this Notice of Commencement.
A N _ i
Legs] Descrtptton of oeerty and address if
34a�17_ �=
General description of Improvements
Address
Interest in property: 6 L.wjr I
Fee Simple Title holder (If other than owner)
Address
Contractor
Address
Surety
Phone# 7ZZ—S S O;;6
rax # 77� �z�y�j Ott 'Z' "�aF
i
Phone#
Address FBI # "' V
Amount of Bond Q O
Lender Phone# m
Address
Fax #
Persona within the State of Florida designated by Owner upon whom notices or other documents maybe weed as provided _
by Section 713.13 (a) 7., Florida Statues:
Name Phone # z
Address Fax #
In addition to himself, owner designates df` O
Phone # Fax #
to receive a copy of the Lienors Notice a provided In Section 713.13 (1) (b), Florida Statutes. Exptratioa date of notice of
commencement is one year from the date of recording unless a different date Is spedfted. WARNING TO OWNER:
ANY PAYMENTS MADE BY THE OWNER AFTER THE Eff6tATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERM IMPROPER
PAYMENTS UNDER CH.713.13, F.S., AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A N0nCE OF
COWAIINCIM0T MUST BE RLCOADID AND POSTED ON THE JOB AM BEPORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
Title: Notary Public Commission Number
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