HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUS BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^CJV
Date: J Permit Number:
z` } -
r RECEIVED_
Building Permit Application SEP 0,5 2018
Planning and Development Services
Building.pnd Code Regulation Division I ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROuEMT L
ENOCATION j
.. _
Address:s W ( LS
Legal Description:
Property Tax ID#: `LV� SU�- (112— (]DD Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OFWORK
vv" Loa" Ab _C�a P,T��
ROT 0, INFORMATION � ` f
ACICUtIonal work to be a Orme l uner t is permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
[�kElectric ElPlumbing Sprinklers ❑Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1 Utilities:Pn Sewer Septic Building Height:
01NNER%LESS E "`fit :' =CONTRA T `
Name C, Name:
Address: . Company:
City: State: Address: tO l7
Zip Code: 4q4Cp Fax: City: p State:
Phone No.__M_L4k4+5��"I Zip Code: qU.- Fax: 7,
E-Mail: Phone No. —1-1 p
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: UD 1Ceg3
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
i
SIJPPLEMENTAL.CONSTRUCTIONIIEN LAW INFORMATION:
ION:
_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.
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 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.
Sign at `e,of Owner Lessee)'Contractor as Agent for Owner Signa of Contrac or/Licen a Holder
STATE OF FLORIDA STATE OF FLORIDA —
COUNTY OF . �(���� COUNTY OF �l IC,ICJ
The foroing instru ent wa acknowledge�/before me Theft going instr ment as acknowledge before me
this day of �' ,20 10 by this day of 20L by
Name of person making statement Name of persoyf making statement
Personally Known ✓✓ OR Produced Identification Personally Known ,,// OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida) (Signature c f Notary Public-State of Florida)
"""", KARS@a). NIELSEN Commission No.
Commission No. �`;�'YPU'' KAREN S. NIELSEN
tate of Florida-Notary Public �"""�� S
1�`Y PUB�i
=„ Commission # GG 207484 ;=a ��; tate of Florida-Notary Public
o,noP°.' My Commission Expires _.
Rs Commission # GG 207484
une 12, 2022 =,,,F P,� My Corn mis ion xp res
REVIEWS FRONT Z PLANS VEGETA "` SEA Tl IP-4f}e 1 , ?
COUNTER REVIEW REVIEW REVIEW REVIE 'SIM" RVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 4477125 OR BOOK 4176 PAGE 2449, Recorded 09/05/2018 10:11 :46 AM
=ECEIYVPED
NOTICE OF COMMENCEMENT
Permit No. Property Tax ID No. �12� ✓L�L DO�-(p t.l -3
State of Florida,County of St.Lucie
The Undersigned hereby gives notice that Improvement will be made to certain real property,and in accordance with
Chapter 713,Florida Statutes,the following Information is provided in this Notice of Commenceme9t. 1
Legal Description of property and a dress If available._ �Irr fnn
General description of improvements J4.S 4fA. I i K > O wG m-0 S4aV<�R
Owner/lessee i
Address ' `t
(
Interest in property:
Fee Simple Title holder(if other than owner)
Address
Contractor Phone# X77 —f-Y_-93L r
Address Fax:# --n2— LIL� —Llti J '
Surety Phone#
Address QTJ OF FLORIDA
ST.LU
Amount of Bond THIS IS TO CERTIFY THAT THIS IS A
Lender MALMO CORRECT COPY OF THE
Address �RG I .
Persons within the State of Florida designated by Owner upon whom notices tCp
by Section 713.13(a)7.,Florida Statues: p Dp®p Clark ee `
® V
Name e#� 2��U
Address Fax#
In addition to himself,owner designates of
Phone# Fax#
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florlda Statutes. Expiration date of notice of
commencement is one year from the date of recording unless a different date is specified. WARNING TO OWNER: =
ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER
PAYMENTS UNDER CH.713.I3,F.S.,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF
COMMENCEMENT•MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTIOri.IF YOU WTEND.To OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
COMMENCMENT.
Owner/L ee or Ow is or Lessee's Authorized Ofilcer/Dhvctor/Partner/Managed Signature
Slguatory's elDfnce
State of Florida,County of ���,,,���// I I !
Acknowledged before me this day of_19 20 ,by ,
who is personally known to me or who has produced as Identification.
�{� 1_Y-1'►�� ���1(��.��r-�viz,
Signature of Notary Type or Print Name
�of,Notary (Seal)
Title:Notary Public Commission Number ��t �`{' 9RDID�lIV
QIoWy i'Mia•ftft N Eigm
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