HomeMy WebLinkAboutBuilding Permit Application AU APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED .Th
Date: Permit Number: I k-/1 C)°c(4-0
RECervED
- • J - • JAN 1
20/9
. Permit..
. _ Building Permit Application st, 4;"g Depart
CetlniTet)t
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
1
PERMIT TYPE: r--
reree
PROPOSED INPROVEMENT LOCATION:
Address: kYin Cr\cik LC).
Property Tax ID#: 5-(r-ccr)5 -cA-2,c) -cD Lot No.
Project Name:T) \fts
DETAILED DESCRIPTION..OF WORK • - „
•
- Øoce . 14010 O. a
ceriae (31Thck I' (yrty,,
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CONSTRUCTION INFORMATION
Utilities: Sewer Septic Sq. Ft.of First Floor:
to
Cost of Construction:$ C?"‘J-1 Total Sq. Ft of Construction:.
FLOODPLAIN DEVELOPMENT PERMIT for structures exempt from Building Code that are the ,
floodplain ,
Ncinresidential FarrnBtillding: Teinp. Bldg/Shed used exclusively for construction
Mobile/Modular for temp construction offiCe: Bldg involved in distrib of electricity:
Other flood Zone: BFE Flood way?Y/N- If.11,.:``
°No Rise Certificate with supporting data attached?Y/I\I I
All other applicable state and federal permits shall be obtained prior to commencement of
OWNER/LESSEE CONTRACTOR:
Name-rp Ic4ct.\--\ Thrxficts Name: Vt-rs A. Chary
Address: ltC ('cc\'j. Lc . Company: i%--Ar(--,r, rerlf,
City: Pie r-c e, State: F-1— Address: ty2); 11E .
Zip Code: 34L4S Fax: City:CX,PeCI-NekYle State: FL
Phone No. Zip Code: -q Fax:
E-Mail: Phone No76M- g'&9--51-1
Fill in fee simple Title Haider on next page(.11 different E-Mail jLt P.(fi'-'ctrirr(liceiNee,,ecin
from the Owner listed above) State or County License 1c6 et-1 I. I
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
30 PPLENtE ,1�AL c6NST1UCT(ON LIEN LAW INFORMATION ,
aye, ? _ e •w a ,. M4)4,-,., .., ,�,. - , .., ,R,.�, ,,3x,.€-'.
DESIGNE' ENGINEER: f Not Applicable MORTGAGE COMPANY: T Not Applicable
Name: Name:
Address: . Address: I
City: State: City: State: I
Zip:. Phone. . Zip: _ Phone:. I
FEE SIMPLE TITLE HOLDER: t\Not Applicable BONDING COMPANY: Not Applicable
Name: Name: I
Address: Address: I
City:
City:
Zip: .. Phone: Zip: Phone: I
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.Associationrules,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. ..
Inconsideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work j
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 tuuice 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 i'
commencing work or recording your otice of Commencement.
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, ..-.-•• i I
4 ,
Signature of Owner/Lessee/Contractor..as Agent for Owner Signature of-Contractor/License Holder
STATE OF FLORIDA STATE OF'FLORIDA
COUNTY OF COUNTY OF 's `' P P.
.
The far ging instru eet was acknowledge efore me The faareoing instrument was acknowledge efore me
this 1�-sdayofC�.. J. ,-20_,Liby this 1'14 daya _.20_11-Ay
i
`i _A-, rti - i = .'`_, oV\P.:
Name of:person making statements Name of person making statement.
Personally Known . . OR Produced Identification Personally Known X. .OR Produced.Identification
Type of Identification Type of Identification_
Produced Produced •
i 1.. .i .t i -1' P 0 y__ 1 �...... -4A l`(Signatur f Notary Publ - (signat .C1I
u ef Notary Public-State-‘ ^11) 'Ai •
Ie Aari')°'ivJULIE S'ELL: • " o1�av' JULIE SNELLJ li
Commission No. fil4�11``; �atpc-state ofFtorida Pu<siic-state ofFicrida
� R ,'�ot� I Commission No.��`�I''��`� N• � �S�
'? g, Commission r CC 195877 ,4s Commission N GG 195877
I ,..Z ;,� MY Comm.Expires Mar 13.2022 I '(e'os,,dr My Comm.CExpires Mar 13,2 2:
i "moat ma %ataryAssn, s M
REVIEWS FRONT ZONING ' S ` `T tl • PLANS VEGETATION SEA TURTLE MANGROVE
1 COUNTER REVIEW REVIEW REVIEW • REVIEW REVIEW' REVIEW
DATE
RECEIVEb
DATE
COMPL1ED
ley.1/9/2019
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4