Loading...
HomeMy WebLinkAboutBuilding Permit Application 1 II All APPLICABLE INFMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: LI1 11 \ Permit Number: C qbtfr ObO-- RECEIVED COUNTY " .7-4,'s„,-, . SPR 0 2 2010 i, F iL O. R ,L D A Building Permit Application permitting Department Planning and Development Services St. Luce County Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 �( Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential c/ PERMIT TYPE: PROPOSED IMPROVEMENT LOCATION;: �- , Address: 6 €-) S 1_n. e c-N- Qiecce. 3liieij Property Tax ID#: 3 Li 1 b -5,33— o 1 7- 0©h- l Lot No. 3 , Site Plan Name: _ Block No. Project Name: li DETAILED DESCRIPTION OF WORK: , Rx_.-Cczc -- s‘rk i())\-c_. -t-- 5\i:ni(e . P4‘4 / ot.4 of Sfc,),L 01 coi4V/4'yl A/e77 ,, CONSTRUCTION INFORMATION: 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 til/2._ ;Pitch 1 Total Sq. Ft-of-Construction: Z(6.-0 & Sq. Ft. of First Floor: II Cost of Construction: $ 10 O&0 Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name LS cilhe.s C3G L.SCesem .15. Name: (xc:Agt\� 1..��r 1 Address: �1 e0Ayk-S li 1 n . Company:.��0��� r1t, LaS"-:19i City:;(s 42C-�C-t_ l State: C- Address: 1. f°73 .st ( v,-.Le C. Zip Code: 3 L-1 763- Fax: City:Q QC n Ss,:a1r- (--- Li(_ State: C—L-- Phone No. Zip Code:3( X177 Fax: 1c E-Mail: i Phone Not? �.60- e1 S (mss . Fill in fee simple Title Hold r on next page(if different E-Mails`in. rel,nc ro$-,rYr c t., . C_O� from the Owner listed above) State or County License C-CCk 3'3 ` L1 5 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. lI SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: 'I Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: II City: City: II 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 represu sentation that is granting a permit will authorize the permit holder to build thesubject 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. i. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects,perform the work 1 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 YOURI 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 YO ' OTICE OF COMMENCEMENT." cj 1 0/. tip. _ 0 9 Signature of Owner/Lessee/Con.eor as Agent for Owner Signature of Contractor/License . •-+ - STATE OF FLORRI[ STATE OF FLO I • COUNTY OF '"I ur -10 COUNTY OF �—�(-) The forgoing inst ent w acknowledgsj efore me The forgoing instriegent was cknowled before me this day of , 20 ) 1 by this day of (Max V ,2011 by ChinrY1 UN\-e2TA end 1 ADI i Name of person making ateme Name of person making st tement. I Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced ft0 LI, (Signature of I`1 ary Public State of FlooN�(� BRANDY MOORE(Signature of Notary P blic-State of Florida) p� - ° Commission#GG 102839 tir�+Y^�s�, BRANDY MOORE Commission No.G 3 I 2d 3 + �i-�!'' ommission No. GG �2 `�' � N , 1,tisf Explres May 9,20 1 �A AN , Al) Commission#GG 1028.T �fFOF re Bonded Thru Budget Notary Services '4). 47. Expires May 9,2021 Ot•t'l Bonded ThrnBudget Notary t:ury o , I REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19 'I