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HomeMy WebLinkAboutBuilding Permit Applicaiton ALL APPLICABLE FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 6119 1 C VPero 'tt Numb : 1 '"� [ RECEIVED ' , tI - ' MAY 2 9 2019 , a .. ._ . Building Permit Appiieation Planning and Development Services Permitting Department Building and Code Regulation Division St. Lucie County 230Q Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select fr©m dropbox, click arrow at the end of line PROPOSED I(VMPROVEMENT LOCATI B -� r _. m 1."�� . tort rrte� ri , - ._ . . _. Address: 1100 (1)1(1(1 5 Refze I . . _ 3L-{q Li5 Legal Description: v&IOW VaY' .0 iJ i le, qive Comma-N.1-n' Property Tax iD#: v3O3 -at i _00is -000/S Lot No. Site Plan Name: 0-so r Block No. Project Name: 3G,�(�rr,�, �1n 04) `Dct0 DIlIn�Xs� Setbacks Front Back: Right Side: Left Side: I DETAILED DESCRIPTION OF WORK p U Ito, -f&' Uks-: s1r,t1 ne.t>v 3.S -vr l 14 s Eag , Fn-Tdta(r& P(IC pmts u M- twi 10 16K kat. ,CON STRycT10ftE INFORMATION `Additi• al work to b(e�ertormed under this permit—check all apply: HVAC 1 l Gas Tank Gas Piping Shutters [1 Windows/Doors [Electric 11 Plumbing 0Sprinklers Fl Generator 11 Roof Total Sq.Ft of Construction: �t ,��ll S .Ft.of First Floor: Cost of Construction:$ 00 UV Utilities: Sewer t (Septic Building Height: 0X741 N'Ett/its' E £ at COQ V.RACf.00 ‘-).-.,...--:;:,?.--,,,::;„::,,,,,,,',;;;...,:'-'-:-.•:-.,...-.. 3, b l < Name P9fS'11n.r Monte. .u!} f ttes TAO—-• Name: M.twtUg( o�f 0, ��(� 1 I Address:�''{�I +`�� s t st Ave, Company: Bp IP r Ain to City: t�J +v i 6VeaCk state: FL. Address: 6t 0 A Tarn a rt Of <0.- Zip Code: 330tiCt Fax: City:k'1k PItat State: r Phone No. OaXtW #'tOt - C215-36114-055.5 Tip Code: 30851 Fax:71a--uto(Q- 8737 • E-Mail: Phone No. 1/)--461-4I.1-l't Fill in fee simple Title Holder on next page I if different E-Mail: 1 (P_A(!e,�Q/Jl.in On. cjyr' from the Owner listed aboiae) State or County License: 00 XI',i1 If if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. Y - SUPPLEMENTAL CONSTRE1CrION:'LIEN LAW INFORMATION: DESIGNER/EL GINEER: !Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: . f ' Address: Address: City: State: Gty: State: Zip: Phone Zip: Phone: FEE SIMPLETMT HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: , Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONIRAC O A:F riDV iT:Application is hereby made to obtain a pennit 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 Countymakes no representationgranting that is a permit will authorize the permit holder to build the subject structure which is in conlict 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!will,in all respects,perform the work in accordance with the approved plans,the Florida Building Codesand 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 j 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 recording your Notice of Commencement. pa 4LofOwne &ractotrOwner Signature of Cotiii actor/License Holder STATE OF FLORIDASTATE OF FLORIDA mum/OF � �rr��'n,,/�'l k�� COUNTY OF t ' E The forgoing instrument was acknowledged before me The fo •sing instrument was acknowledged before me this nt day of tilfi,t•L ,20 I by this Z%' .ay of M(,(,!4. ,20 l by �I is O(na2 F- too e. .ickk F Oo /e Name of person eking statement Name of persargaicakingstate rhent Personally Known OR Produced.Identification Personally Known ✓ OR Produced Identification Type of Identification Type of Identification Produced Produced -a / / ; / a72/-el-/ w_ft,4 - 471,zat''(--- . sr 1 P.s w�Al, m ..an._• F 1 (Signature Np» • bfic-S€il#fNfllSdrElAWELL y (Signature r= t'•ir:s .4. ate.f to 'da ''.- Prk.. Notary Public-State of Florida ` ���� ���� $ CHRISTINE J.COff��..W�E�l,� ' Commission 4 Commission# rk,. YP a blit-Statrlro"ffb4ida = Ip839 Commissio r°3. ` 1/e? My Comm.Expires Aug 21,,2020 l Commission#GG 017839 =onded through National NotasY Asssn' 4 �,� 11 My Comm.Expires Aug 21,2020 l Bunted Liuough National Notar Assn. REVIEWS FRONT ZONING SUPERVISOR ' PLANS VEGErATl611 SEAT R'l`LS PPLAIGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 It Vii._.._......,__...... ..._..._._,._...._______ .. .._..__ .. ... ... _ ...... _. _. ...._......,. _. ...... _ _ _.... .._ ._ _.__...