HomeMy WebLinkAboutBuilding Permit Application I
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a'gI9 Permit Number: C o7-50 57
RECEIVED
i
i ;4;,:--P. 7-
, - k MAR 252018
.COUNTY.:.° Permitting Department
._.._._..,_.__.-,-.___._. _._.___ .._ Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553Pax:(77 )462-157g` COltinieirtial Residential_Z__
PERMIT TYPE: �-( le- it a'll - 11014/n_4 C (J-nG Oi-
PROPOSED IMPROVEMENT LOCATIOi l 4 t , ,.r.`4x ): :, }gg x } : '.s r ,:; k},`ixz..:, t q
Address:• OQ Ail E L M Aq. DR, - A - 01
Property Tax ID#: L S// �_) /
— .0 - DOD -S---. Lot No.
Site Plan Name: Block No.
Project Name:
r <'.1"f"' r ,�Q S v �, i y : - ,J;
DETAILEDrDESCRIPTION F WORK ' ` " Ytir `k i n'
R - f e la (G e,\41 5-+-! l . (.2 (d( /%,) t'r ((Oh CI/ i o h ivz SS S' ei�
(,� ! lie_(,J 600 i� 7d S 1=n d / q `�S ni
cAl Lc/6) A()0
{ k t f 5 5 i 1 t t S 4{ 7 ) ,
CONSTRUCTION=INF_ORMATION - �,,7twr g 4 t k k � } ' J 7iz,4 �,) ! ,k
.- .:c �. -k °4. k. s' '?r"'^;ti).,Fr.� : .7.a,x'� F*r _. Y. L.> •n" - `}`'�M1:r+ �..,J n�a�,�5%. .•k,M1s i.
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters —Windows/Doors
Electric _Plumbing _Sprinklers —Generator _Roof Pitch
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 3 , q OD f Utilities: _Sewer .__.Septic Building Height:
` . -,„,,,,,,,,,,,,--4.,,..„-
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C)OTRACTOR Xy� 3 .:. } * _ xg OWNE / EE " Oa ta2 ,z5r J, 6 � i N :. � rA1 a� . i
t"
Name 'Darioewe-2-
(�DC�I� ! Ue Name:14g(31l i l R Coq,I+ OP1Iit �17ee
Address: 10,2 6 S ,�6 13D La/!e Company:` , )kg S '. -- p' e_S-
r"
City: lA G'(1 �i i State: fil— Address: (,3 0 g Vv hi� (� `�� � ,yt_Q
Zip Coder .33 7 6 ' .Fax: /i - `
/�' City°��' �r E` IT 2 L.
State:F.
Phone No, 3 067---.- ii?q- /3i 6 3 Zip Code: Fax:
E-Mail: 4. (Or- Phone No '7 — q -9-
Fill in fee simple Title Holder on next page(if different E-Mail rot (711 e.,c ---q.t/' ..,cC/a )_ ?)( • r? o tv)
from the Owner listed above) State or Cottty License ac. 1 g 1 1 3 0 g
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.
.vin✓ 2ET T. . 3` .,
ff. kSU�PEMENTALCoNSTRUcTiONUENAWFORMAfO 1 r F F
.. 1,:.. f _� 3 .., .'iyV ,, J .?= y , s s3�' � }= ns '�. i N;,rv- rAF . ., �y - ;
eW`A
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 thesubject structure
which is in conflict with any applisu
cable 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 andSt.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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." .
h ,I
Signature of Owner/Lessee/Contractor as Agent for Owner Signat a of Contractor/License Holder -
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF `,1- W,( / COUNTY OF .5,1- biA
The fo of a instru acknowledg fore me The forgoing instrurne w, s acknowledge ,efore me
this day of ��� ,20 by this 0.day of II /( ,20 t by
Name of erson making statement. Nal rx-YlaS go_9-671-e/d-k______ me of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificatbn Type of Identification )( p�/
Produced /-b 0( Produced C�L�
0 Vad_....------------, 000-7.—e
(Signature of Not. (Signature of Not,. . Public=State of Florida)
ELLEN VAUGHN .
Commission No. =4:40.111,--:-.State of Fto(g�Notary Public Commission No. ".a, ELLEN bT.- HN 1A
"" _ Commission #GG 270079 ` ate of Florida-
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ip1ILi: Commission Expires ,i" ,oma; Commission ; N°tary Public
Oatobar 22 2022 _..._ ., •R,�•,. . ;
_..._ _ _ ,/;"1-;� 0 ommission Expire
REVIEWS FRONT ZONING SUPERVISOR PLANS VEG • 4-7"---------21-, ;k_
2, :o�/pAy�IG• iVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW " " •••
DATE
RECEIVED
DATE
COMPLETED
1ev.2/7/19