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HomeMy WebLinkAboutBuilding Permit Application -updated 12/28/18 All APPLICABLE INFO1MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 rte k I P Permit Number: i o ® RECEIVED ate, -�- DEC 2 2018 F' €] t D — „'` Pe fitting peAart _ Building Permit Application t Lucie County ent 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 \c/ PERMIT APPLICATION FOR: Ter., ED4„,44,17-'4.11, ... " --,114110,1%,Aftile''Wm' . t. ° " � � d ' �y . � k . _il§ ' ,vitI al °a5 , ow• 4, a .Es. Address: \r5%20 © ('Cc31.1f—;'' A() Legal Description: Property Tax ID It: 2 ' — )1 l —000 2.°-0 00— (e Lot No. Site Plan Name: 'MO r CO Block No. Project Name: 11) ®v r4 t ) !y Setbacks Front •1 O ' Back:2 I. L3 Right Side: (3. 5 Left Side: ./�4Il r� rw}� �`a ��E!#�/$\}} j,/aka F« a a` »`". h;-Q 9$Y 7a 3,w "Ry'p�, �. s `1/.09 -I i,,,,,...,„ ,k m !•+. `5i i..a1 Q _t' �- "� ®t�\a,\�'> �4 S , kd "1 „,,,,,,.,,r);A:7.14- r4� C= : "` '*;;;t-47,5',.. '� x . 3aa 1#,`. at:k :;.. '1'.."' I <C��W .r." >'F9 y, , ^. ' `� v ,�.,, s,:� # }, 2: :x 9 , 6 4 °�6ad '0 1`10 Ole 0(1 ` ��G'� CAO tkfd biaf A e 6' 7P;Gke /, d I r 941E � � MA4449,NI- ,p"i, : }y i;"I�'x *''°, CS 'app "" °Py,E° g,d, m,dz a- e-;.'era" 6.. a,�.a�* b` 44,gt#ie • �' �p{� `a' 1Y �` 5 t , ,, :,:0 t v'".•, y b,ga..o ,. a �«n o-y A ,,x p� .. ` : 1, ,F° 1 � V 1 � Wi""m t -°', }a '� `5ns "`•z. +e'`'{y3_ . 'Nle' "rr e v i ptplyr �2 ^n� IS y. :g a°�ti:# " °S �"r �. Additional work to be pe ormed under this permit-check al that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electri•• _Plumbing _Sprin elow _Generator Roof Pitch Total Sq. Ft • —IA ion: I 0 ' (A follirillrof First Floor: Cost of Construction., I clO6 Utilities: _Sewer _Septic Building Height: a,: ti x g a . .'�: ..k � ,.. 5y.. "°. a '^at - .. �c;a+ . .4, ay�1 •... ' ;a aw o iiVi,,r�`s>, ,-�.a. ' ]may! Y � $.°�"' 9 +�' R° �. x7 - d w° � 4 • "a A" *L`�. �agn 76,7' " V:-..-^8/16-.. �R TE:SS 11 S' t p 1"' ga,� $ o"` M'.<� Na fklAt E �Y S# �a�,4 7 11- s �. i a �e4�.�aff aa.�q� Baa>� a*,"� a a-,��5;`� ..._'�° � ��`�`$�; .�'�r.` +I �'� 9. ^°a� . �� � ;.4"`m � "I°: � :�{� .. > Namek;M ®`6sN® V—) /1 a Name: • \ Z �� Address: O OOM ,, Au ` Company: :. , City: f r` - r-1'i tc i.6" 1 Stater-) Address: Zip Code:---)541q-43 Fax: City: State: Phone No. `J9 - 71G, -. 2.,-1 6 2- Zip Code: Fax: E-Mail: °,' ;e, km �6(1` , CO in I ePhone No Fill in fee simple Title Holder on net page(if different) E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. =a '''.• i yaw: °b ;,,Wit; z, fN- I°-u TQ ra-wm�NM f c ' ' e a 4$; .- v 1: i n .„. ,+.. �p = 3'7 aw e r"�e. t :r ° �, � 1 .S ,.�. , � s ` ,•! 5,w� 4",...:i.,-_ - t; i''`4�74..yaa 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 represtructure 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 recordingyourNotice of Commencement. Si ture of Ow er/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder. STATE OF FLORIDASTATE OF FLORIDA COUNTY OF ' Sir.DCA,E COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this n-day of `arz C ,20 1 a-by this day of ,20_ by ( rv) M Q-> rt--J Name of person making statement. Name of person making statement. Personally Known OR Produced Identification*----- Personally Known OR Produced Identification Type of Identification 'Type of Identification Produced (rL D(._--- Produced - _elid..,(...,t I , (Signatureof -e-------1-......—....._,,_14? . • (Signature of Notary Public-State of Florida) ,� 4'41,,a., ELLEN VAUG H N ' ':° _State of Florida-N Public Commission P , -fin_ ___.__. � 7t1 Commission No. (Seal) 1..,o. '—'1,,,'i i��P`; - sion # 27 079 ,��or;\',i My Commission Expires n,mi Ge os: ii REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17