HomeMy WebLinkAboutBuilding Permit Application , I
To: Page 2 of 4 2018-09-26 18:27:55(GMT) 17726733383 From: Maritza Ramirez-Carpenter
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AU APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO:BE ACCEPTED
Date: 9‘'2-1 -20 it s, Permit Number: - VC1 0694
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Planning and Development Se vices
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'• fluilding end Code RegulationDivision
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2300 Virginia Avenue,Fort Pierce FL 34982
.: Phone:(772)4624553 Fax:(772)462-1578 Commercial Residential
' PERMIT APPLICATION FOR: —
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Legal Description: ----4/ ZO
. ' Property Tax ID#: ,2 LI 2-c) - 3 t t - .t.-_-) Lot NO.
Site Plan Name: Block No.
: Project Name:
Setbacks Front Back: Right Side: Left Side:
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Mechanical Gas Tank Gas Piping Shutters Windows/Doors
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‘.."—Electric A Plumbing __Sprinklers Generator Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ i i., C-1C.:)=CO Utilities: Sewer Septic Building Height:
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: Name c-rIne-yritve.„5 Cc'e-e--.1 Name: iftl\airsA-l'in, Ca CP'e-vijrca--(' 1
Address: 21 C45 \ aCompany: rhte4 K --- ,
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City: i-r '?iceL.„ State:R..... Address: 1531 5-E-...,'S:vi-il Nice-Prtej. 4— 0c .'
Zip Code: 5t-teal Fax: City:'Par+5)-:Lci'.6 tf_._, State:,
Phone No.i7 A-330 -45ct 8 Zip Code:-134-15;..). Fax:
E-Mail: 'v'e.C..1 ,e:. -ic-A-- _;. •-, . Phone No Ti -3751-3,2 .1
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: . Fill in fee simple Title Holder on next page(if different E-Mail mar 1-r7.,,,,L,%r.A fleai,--111e,r)kiettLynr:(...'.01-yi
from the Owner listed above) State or County License C44
If value of construction is 2900 or more,a RECORDED,Notice of Commencement is required.
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To: Page 3 of 4 2018-09-26 18:27:55(GMT) 17726733383 From: Maritza Ramirez-Carpenter
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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:
I City:. City:
Zip: Phone:j Zip: Phone: I
'' OINNEV CONTRACtOR AFFIDVIT:Appiicatian is hereby made to obtain a permit to do the work and installation as.'indicated.
1 certify that no work or installation has commenced prior to the issuance of a permit. I
St.LueieCounty makes no representation that is granting a permit will authorize the permit:holder to build the subject-structurewhich isin conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consuitwith 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,per form the work
inaccordance 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:resuit in your paying twicefor
improvements to your property:.A Notice of Commencement must be recorded and posted on the jobsite
• before thefirst inspection. If you intend to obtain financing,consult with lender or an att or , y before
comrnencin_ we k or recordin•' our Notice of Commencement. _
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• AtiVit 494 bill .
Signature of-Owner/Agent/L eefContractor • 5.igrraturee of dontractorjttcens 4older
STATE OF FLORIDA -, • STATE OF FLORIDA .
COUNTY'OF e-----,17- .I JC.k ..._ • COUNTY OF Ti I_+,9e_t ....
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledgefiI before me
this.-2-1 day of ' ' ;,'2p I by this2:t day of 5Sett. t 4,- ,201°6 by
(Name of person acknowledging) (Name of person acknowledging)
(itf , { , sem,, _�
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(Signature of Notary Public-State of Florida) (Signature of Notary'Public-State of Florida)
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Personally Known s Personally Know OR Produced identification
• Type of Identification?: •J.it. MICHAEL f9 R IAR" Type of idCntifi ti�5i< . ., —
MY COmmi5S10N 4 FF234840 , Produced �: . ...-. E" � R
Produced Q • ; , - �`'v�r+ihtiWsioN
•:r ,,,d�'' E'xP RE$May 14.2019 ., a.« .. FP230r3.4G:
.a C �o.:. EXPIRES 9U 8, 1?3.
Comrriission No. �� :� rW:Mdk icon l OrRm[SSiDn:No >
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REVIEWS FRONT 1 ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER f. REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
`DATE.
RECEIVED • I
DATE I
' COMPLETED I I i
ley.V2014
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