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HomeMy WebLinkAboutPermit Application for 5671 Sunberry CircleAll 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 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: �WiPROPOSED INPROVE MENT LOCATION ` ' k 4 � Address: gt)41 I a Li ( Llc Legal Description: Property Tax ID ##: 13 1 c-� - '5oQ 11, Jq - GO© ^ -1 Lot No._ Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 11 �_e -cor 1 1Y -e J 1 t (- i H wff-'r Lu a r l I Q K, Co CQNSTRUCTI0N INFORMATION: Additional work to -be performed un edmils permitheck aVt —at—a mechanical _ Gas Tank — Gas Piping _ Shutters Electric _ Plumbing _ Sprinklers Generator Windows/Doors Roof Pitch Total Sq. Ft of Construction: + Sq. Ft. of First Floor: Cost of Construction:$ �FL400 Utilities: —Sewer _Septic Building Height: nw owlva/ss' co NTRACTOA}h�� i' Y.VJ s Name LU 1.S lbba 1 i t.l i a ` ,t L s1c Name: '_Y1L,C--a Address: ca3 t C C, couf--}- Company: eod AirQ} rlS�[•� Clty:a `CS(�[lli MStater Address: (JI_�-._'5_C� Lis'` Zip Code: 0-1 Fax: City: V6-+ _i�) I ecce State: -f ---(— Phone No. zip Code: 5"95 1. . Fax: M a A01- .5�>q E -Mail: Phone No 1 D- CP 3L-1—()L{q 1 Fill in fee simple Title Holder on next page ( if different E -Mail UC'i C) E E� ► • C'acr--,) from the Owner listed above) State or County License IK 1 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. '-� k' k 3 k >��T'RUTION �. — LIEN LAW 1NFORMATIQN E . ` 'ff T—Er p a �+� .ks_p DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to du Lne wui r, ai,u 105La 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 the permit holder to build the subject structure which is in conflict with any applicable Nome Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Horne 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 recordin our Notice of Commencement. GSL G ,� Signature eOwner/ Lesse on ractor as Agent for Owner Signature o Contract r Li e Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF �COUNTY OF The fo�ooing instrume t wa acknowledged fore me The forgoing instrum nt as acknowledge fore me this day of 20j�b2—y this day of 20 by (Name of pers n acknowledge g } ((Name person acknow edging } �r (Signatur NotaK Public- State of Florida } (Signature of N y Public- State of Florida } Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification y wood UI se Type of Identification W -V Woody Ulysse Yp Y Produced J;Iz�P�� OTARYPUBUC Produced p� �TA-ARYPUBLiC g-�STATEOFFLORIDP I TATE OF FLORIDA o Commission No. rr>j1979ti7 Commission No.CC� /9-9'/? .,,t°�Itg79f17 Expires 3/1912022 . Expires 3/1912022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.