HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l -30 —19 Permit Number: ;a r 05 `CI,
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RECEIVED
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CO:JUIN-1-Yr ... MAY 01 2019
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Building Permit Application Permitting Department
St. Lucie County
Planning and Development Services
1 Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 �/
Phone: (772)462-1553. Fax: (772)462-1578 Commercial Residential 1
PERMIT APPLICATION FOR: 190,,,,o/; /oh •
PROPOSED IINPROVEM LOCATI®. m:;, - g. °q; . °
Address: 1329 ✓Y*1f 81 i Jedsel 9egiLe4, R. 3 9 7
Legal Description: 114H[e3 ° 514}1A iHe. (587"907/) V
Property Tax ID#: 9502 -SQ/-/51Z- 000 - g Lot No./3,49
Site Plan Name: Ai ttifi .Ti/ani Block No. I'
Project Name: /.?29 , i�
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Setbacks Front Back: Right Side: Left Side''
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QWAILEDDESCRIPTIONa 1NORKQ.
Gorr,/e/e - Ie ia);/an aia/ p ..1ova/ of 78y s ' elo.Ii/c A ai.ie • c a
7/4t.14 eV 0Y1
a ,-;,. ,.e, .e�°: � .e. '�. . $•
CONSTR TIC® DNIFORM i TIONo :° , - P°,
Additional work to be performed under this permit-check all that apply: � V
Mechanical Gas Tank Gas Piping —Shutters _Windows/Doors;'
—Electric —Plumbintg� —Sprinklers —Generator —Roof Pitch
Total Sq. Ft of Construction: 7S 7 Sq. Ft. of First Floor: . 7 gy
Cost of Construction:$ I90,2 on Utilities: )(Sewer Septic Building Height: 71
_ R/LE-S�SEEo_ R v'+., °,v,. , a4 '. : ° °
° CONTRACTOR? � a
Name .79 Sri e 4 :E..'I/14 Name: 116/r» .53-ef7L,4 1/ i
Address . /3.2 9 •./y#/•s . 5/v/ Company: 4d s,i c-, ' ,UOd.c47` Svc. i4 C.
City: Jensen. 8eaeA i . State: P6 Address: 161. ✓4z: 5;0,466,-, ..f I
Zip Code: 34/957-3203 Fax: City: J€n fey; ', 8 ed_ State: eL•
Phone No. 705% 375-74/2o Zip Code: 34'757"' "Fax'772"-132 -2/9/
E-Mail: Phone No 772- .2.10- 37/S
Fill in fee simple Title Holder on next page(if different E-Mail a�[14 pi.3"MI til ;A C e%/aA a4• cool
from the Owner listed above) State or County License Ce* /2 5/`/k/
1
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
.SUPP EMENTAL CONST° CTION LIE= LAW FQRMATIONQ a :Xi!. , x
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 posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or r ordin: e. .Notice of Commencement.
. W......... ... e...
Signa of Owner/Lessee/Contractor as Agent for Owner Signature o Contractor/License Holder
STATE OF FLORIDA � c � STATE OF FLORIDA i . l
COUNTY OF COUNTY OF Ll�
The for oing instru m,ent was
acknowledge before me The forgoing instrument was acknowledged before me
this V� d \,sa
ay of I.V 114- ,20 ( by this —day of Il� J__ 20. _ by
QCT 3n``1 kin a&,ObV) L5r0 I etiTh
(Name of person acknowledging) (Name of person acknowledging)
61j01- - 69--WAJUag ----
(Signature
of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Ide l ficatior --•--h--�--^--- - .--,.�
Produced C, c ' Produced iC-hc-- ,,,,pYP/,‘, ELLEN VAUGHN
1 :0- I ��State of Florida-Notary Public
� -* ^ *= Commiss wARG 270079
Commissions o��,liii FI I FN VAUf H� O) Commission No. ';`iiiH.q= rMri' bli
o4 �- k -,744111��r My Com Expires
=*�. k _State of Florida-Notary Public October 22, 2022,
nu
a = Commission # GG 270078
+
`'i'�N-'�oa,`r? My Co mission Explr:s ,
or .s Oc o,:r2, 2022, •
REVIEWS .----:•:::•'--.---=•••••••:!----1-7-''ERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW ' REVIEW REVIEW
DATE
RECEIVED . • , ,
DATE
COMPLETED
ley. 7/2014