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HomeMy WebLinkAboutHirschAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application Punning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 ` I/ Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Y 1 � PERMIT TYPE: T l PROPOSED IMPROVEMENT LOCATION: Address: Property Tax ID #: C� — — Lot No. Site Plan Name: Block No. Project Name: [D�ETA:ILEIDIDESCRIPTION OF WORK: .� I , r CONSTRUCTION INFORMATION: Additional work to be performed under this permit —check all that apply: Mechanical Gas Tank _ Gas Piping _ ShuttersWindows/Doors _ Electric _ Plumbing _ Sprinklers _,•_ Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: i Cost of Construction: $ OQ300. 00 Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: -z-- i Company: •�cr tel/�* S, Name i Addresss:�0401 (10 !� Address: -T City: i c State: EL Zip Code:31+9(' a Fax: OnQ- ' ftL Address: C� City: L Stater Phone o. i E-Mail: 1 `• Zip Code: C LP Fax: Phone o Fill in fee simple Title Halder on next page (if - e t from the Owner listed above) E-Mai 1r State or County License '2) 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. .r7 C. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER; Not Rpplicable MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip: Phone Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE BOLDER: 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT ,...rE. ^0 11M . ra,fW13 Ilin AN ATTnD1UPV Gt1PFnRF P;;rnPniNG YOUR NOTICE OF COMMENCEMENT." t711 n r w%iw% Signature of Owner/ Lessee/Contractor gent for Owner Signature of Contr ctor/License Holder STATE OF FLORIDA COUNTY OF STATE OF FLORIDA COUNTY OF _4 The forgoing instrum n gas acknowledged before me T� 202Oby The forgoing instrument was acknowledged before me this 1- day of �}i ('��- , 20 t�by this l day of -- -- 1G U_*h V— -n Name of persoh making statement. Name of person making statement. Personally Known V OR Produced Identification Personally Known _ `// OR Produced Identification. Type of Identification Type of Identification Produced Produced /Z� M#,, a�4//z RICHY-rIONIIES -18— (Signature of Notar iof Florida Commission # GG 966788 (Signature of Notary Public- State of Florida Commission No. (sea]) Iy Corr�on Expires Commission No. , Ivta 2024 Nota y Public S F} S FRONT Co r�U\4 M VEGETREVIEWS ATION REVIEW SEA TURTLE REVIEW MANGROVE&W6COUNTER REVIEW C�9�n E DATE RECEIVED DATE COMPLETED Rev. 2/7/19 LOT 12 BLCICK 21 LOT 11 8LOCK 21 INDIAN RIVER INDIAN RIVE LOT 10 BLOCK 21 (E(STATES CG )5 ES�T�ATES UNIT' j INDIAN RIVER 11/EfLL10�k SEP utFLt1D PG 57 SEP cps 10 UMT 6 >75' NO INTERFERENCE >7$` N4 IN cps 10 C 5P ) TERFERENCE >7$' NO INTERFERENCE IN1ERStC %04, F q r c� v �1it ) w Q I 'P 'M 4416' O.24W O.25'w k .0'N O �S„OF k X- 0 •--s END PRC PSM 4416' "87,"500'02'14"E 80.01 0.25'w 560.07 C ' 80.00' P o ssa.00 © �. �-F �Q 1,6 SEAGRAPE DRIVE .7s NA VD Iet$ $0' R/W -. 20' ASPHALT R0A0 N ril 106 NOM1 pI;-" g, Nn 51 �� "�A 4