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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q� Date: l 1/ gal /1 Permit Number: /Tj.'/'— C0J iIIIIIIIIIIINNIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIk I J T F L G Ra I Da. --� � NOV2 91018 -- Building Permit Applicatio .n Permitting D� Planning and Development Services St,Lucky ,pertinent Building and Code Regulation Division '�/t, 2300 Virginia Avenue,Fort Pierce FL 34982 / Phone:.(772)462-1553 Fax: (772)462-1578 Commercial Residential - PERMIT APPLICATION FOR: d0 5 `- x +a_ - t h ,y. c ,7.n-#�`� i e,, ^`;� z' i xt 7 °e ,- ROKOSE© 1NF OvEMENrLOCAT1u1 -, � ,, �, 1, - -,b t,mak„A,, w Address: 10 LI c1.4- (-0 Avk. 7ç4 7 e's(-C_.0 7L 3 /'i8 Legal Description: Property Tax ID#: 31 O el - 1/3 ” 066), ` 00 o- S Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: t 1 a: x t ".:...s .�: - g �,., t� T t o f:Mf:Y+ v�4 . tjA, ar q:;Z s '` t L.e� ' �".°,� �` Q A1Lf 7 y :twl!1PT1Q.QF,�y}RK- S a Rto,z- y ` P ,:$ oo �b Y L ` -- S it-vi\e4 Le_ AI 1,0 ,.,A ou)s Go; -IL 1 lifOric/1- 4 0 w ii" m�(/'��,� 4`.. w„�R,,.: ietr., "s. s E H. ^.fix r4; �'»a"� Ps*, t,s z w�.. 3's, t.vv,v 1 h'ra3�.° `�o '' , a 3t:46 '� • � �i `0 =� f 4 i !. 3 M?��" 3� '_}'� `e'*a 3 `, m..-, .. t; s m.. !*:V-f«.t, ^�^ :'4,-'-'Wt -t�«,,,,--,,,, e4,,,,,,,,,, ,:;,‘'�-'_. -;�h��Y+.. . . [ .�Y...a�y. '.- �?;a-,,.d _.��r; C„i ,>_.. ..�_.ate. "p'��;�� a,.i:.�»a r,a� > : Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters S, Windows/Doors _Electric _Plumbing _Sprinklers —Generator . _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ b Q 0 0 . 0 . Utilities: _Sewer _Septic Building Height: t � Y`� ' ''3 -��'��� S �� "��y �ti.F'°��' `�`�ss rw i '� � � ern ��n �R�,�'��`s � 6 ER L am ` � , � . Ci batt` OR�.SM:: �� ti_1�; � � .n, ,,w,?., °? tom,., o .�h .v,.Z„F:, ::� . ,, ,..-. ,v.1,..m-,,t s , .' -s 3..”, M-- ,c,`F.E.: "- ..-cepa. .;c"�.,�z _..�Ea°e.,���... '`.�'»'�_ .�,�« . .. - _-' Name Tonto 1 (/.2G o1 Name:-Fran.K;.1. G610-PA:-ir--- Address: Cl 0I.( 0 SGS.V -bJ` Company:.r:)1-Ao✓k_ CAA e,1 6- tic^ a .- )z.4Qrn}p. City: Tor i erCe State:tL Address: w 3"1 5u0 .2-E-;'14C-;pi:.Avk I Zip Code: 3uq 3 Fax: City: Dr - S} -t._.` State:TL Phone No. fla-- Bag- 410Z Zip Code: 3K9 53 Fax: E-Mail: Phone No 1 a- 519,- 6-7-5 Fill in fee simple Title Holder on next page(if different E-Mail l'cran k:t. et l 1 so 0 et (IA Cif from the Owner listed above) State or County License CI C 1D b 06 c If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. ;�"�-v+""t'-„�•..� ',P..:y .,h.�� r� ��sS.Ez g a� ..9"�w �ue�cS;< "c� .�a.3- '"��- A -,+fiY��°.�.5?, .a-��c''zi. "�s�-�'a4i '$ms's ,:s` "�.i„' _ql"� .��1 r.�� c €w ro r” i tea`, m- -; ? El � Irk{} ,�, C� *i I to a 'r 79! 1Y4 r. !.,,,W6,.� rya°gym,,...,r, -.:i,.g-li' t.;n.a �.:i�' Aillt -4: �` '" `=5= n'''�*'',144004g61 `y s'"" k r y,n s> 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. 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 pos -. on the jobsite before the first inspe -'o . If you intend to obtain financing, consul►with lender or a a .tt• ney b:-ore corrimenc' g work . r:cordin our Notice of Commencement _.,„,....y z. 0„ r Signature of Owner/Les It/Contractor as Agent for Owner Si..ture of Contractor cense Hold STATE OF FLORIDA , STATE OF FLORIDA COUNTY OF L ftci(__-•- COUNTY OF 5 C�,loe The forgoing instrument was acknowledge¢_before me The forgoing instrument was cknowledged before me this �-(-1,day of n)(,/, ,202_ by this 39 day of A(Y ,20 tt by Oran V&k,}(r (e{ rYcr N1L_Gcl u u - (Name of person acknowledging) . (Name of person acknowledging) 1Le,L tr() � � , r , (Signa ure of Notary Public-State of Florida) (Signature of Notary Public-State of F orida) Personally Know ;. .. i: 'r•duced Identification Personally Known !.: �. •,• ced Identification Type of Identifica on,����,,, Type of Identification `<PR p4 , ELLENVAUGHN ° gPRv/ ELLENVAUGProducedd i 1 Z;71 _ Produced i=( — =°L\° .t Florida- HNa NotaryPublics _•� �.` Notar P 6 mmission #GG270079 ;�iii,a; Commission #GG yublicCommission No. . li‘k,,,:::; -EI'Qza‘lcmo y Commit Bxplres Commission No. °%';;, My(Sea�h)ssion Exp es9 Ootober 022 ctober 22, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE ‘- COMPLETED ley.7/2014