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HomeMy WebLinkAboutPermit Application 4160 N A1A LobbyAPI APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: _I-- 1-]- 1 9 Permit Number: Building Permit Application Planning and Development Services Sodding and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 3498.2 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residentia PERMIT APPLICATION FOR: Address: LA l LPO C\ l f\ — Lobbu Legal Description: Property Tax ID #: I L--1 SCS - co C) -- a Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 1+ Abr 1 I V Ll I `- i F��_ 4-� jamonal wOrK —"'Mechanical Electric e pertormea unaer Gas Tank — Plumbing Total Sq. Ft of Construction: Cost of Construction: $ L1 , LJ permit - cnec _ Gas Piping Sprinklers aii tnat apply: Shutters Generator Sq. Ft. of First Floor, utilities: —Sewer —Septic _ Windows/Doors Roof Pitch Building Height: C?WNR/LESSE[;: - ry l y5}} EoGONTRACTiDR�s HS .. .. Name(')CCCJ`11C,UE CcXYfU > �i :t. ic: • i �C,+' Name:.. Address: 16 3 +-b Company: [ AI,r 56 (, +iL-Y-\S of-t:�7L_, City: _r( ch State:F( Zip Code: s�pC] Fax: --I-] Phone No. _ `j 1 _ Address: i%90 CoblCir-G City:State:-f—C- Zip Code: ,2)L4CILJq Fax: Phone No T-) - lD �S(I-- Q*4g ; E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail , State or County License If value of construction is 2500 or more. a RECORDED Notice of Commencement is required. ���;31STRUCTIQN LIEN LAW INFORM;4TION 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 do the work and installation as indicated. 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 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 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. Signature Gd Owner/ LesseoorArartor as Agent for Owner Signature of ontractor/Licer s�}e er STATE OF FLORIDA / STATE OF FLORIDA 11 COUNTY OF r I COUNTY OF 7 16I The forgoing instrument was acknowledged before me this l "day of 1 20� by (Name of Berson acknow)edging ) (Signatur Notary Public- State of Florida ) Personally Known OR Produced Identification _ Type of ldentifj'c_ation Produced >��Vgl J ' Dlysee i2 Commission No.m#GG197907 ARYPUBLIC FLOI�lDA M *19/2022 REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED The forgo.ing instrument ws acknowledged efore me thisAtiayof 2 by (Name of person acknowledging ) r r� (Signature of otary Public- State of Florida } Personally Known OR Produced Identification Type of Identification ProducedL?r) � � �` �`' o©dy Ulysse .�,,�� __ NOTARY PUBLIC Commission Nolr`- /q �$gA-XQ OF FLORIDA '. o Cornet# GG1979p7 SUPERVISORI PLANS I VEGETATION SEA TURTLE I MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW