HomeMy WebLinkAboutBuidling Permit 1
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2
Date: Permit Number: ®� . 03��
Building Permit Application JUL 19
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
St.Lucie(;owity, i:�-
Phone: (772)462-1553 Fax: (772)462-1578 Commercial _ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSE-D-IIUIPROVEME,NT LOCATIQN
5 . DCc
Q 5S o e '.� 1� - � J��nSer�-ea�eh JL 5
Address:
Legal Description: _.L.S�d�l(�� z T_ 0_a`( 1 o
Property Tax ID#: 4SO2- (o b l- C00'?T�,- -OCA 0 -' Lot No.
Site Plan Name: ^ice 1 ' �1 / Block No.
n
Project Name: 1_S�LYV1�+1 Z X l -fty0 � to I n
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION IF WORK
A„nc� dOteS
CONSTRUCTION INFORMATION -
Additional wor to e❑performed under this permit-Check a apply:
HVAC be
Tank ❑Gas Piping Shutt
er
Electric Plumbing s ❑Windows/Doors
11 _
Sprinklers1:1 Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ OZt ago Utilities:InSewer Septic Building Height:
OWNER/LESSEE =`
;CONTRACTOR
NameYAG ct Name: e
Address: J• o eC,n p Company: r C,
City: )e&-C-VN State: 'FL Address: Jct 1 t-32. -&Xy_CV A
Zip Code: 3 y g 5_1 Fax: City: Stater,
Phone No. -1-1 a-2$S- $3310 Zip Code: 3 y 9q4 — Fax:-_>3kA
E-Mail:�1 i (2, uAom- CD t8 Phone No. _'(Q�-
Fill in fee simple Title Holder on next page (.if different E-Mail: d—S* CJD. -CD tYI
from the Owner listed above) State or County License:SC 131 L S 12-63
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUP,.PLEMENTAL CONSTRUCTION LIEN LAW INFOR(VIATION:
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:
I
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 recording our Notice of Commencement.
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SignatureVownRe,,YLessee/Contractor asAgent for Owner =OF
of Contractor/License Holder
STATE ODA FLORIDA
COUNTY OF_ Lc. o COUNTY OF
The fo oing in trument was acknowledged before me The forgoing instrument was acknowledged before me
this day o 20 Eby this 1q' day of Ok. 20 L—L_by
(Name ofVi-son acknowledging) (Name f person acknowledging)
(Signature of Notary Public-Stale of Florida) (Signature of Notary Public- ate of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification�P_ro.duced._
`�- `- ,I� � s� d- 'S #;. _ A�Sn'1 tNGRAM
Commission No. x,— -- (Seah)��- mmission No. d ;2 rt �- NotaryP r
LASHAHNA INGRAM r State of Florida
Notary-Public-State of 1" 9f MYr Comm.Expires Dec 20,2018
srF It/249
° M ;y Comm.Expires Dec 20,2018 '{ Bonded through NationahNotary Assn
Revised 07/15/2014 , %9rF oe Commission FF 177249
Bonded through National Notary Assn. '
REVIEWS- FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
NOTICE OF COMMENCEMENT
Permit No. Property Tax ID No. �"r"�Z•LDS bCS" G "�
State of Florida,County of St.Lucie
The Undersigned hereby gives notice that improvement will be made to certain real property,and In accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement,
Legal Description of property and address if available 3--atmy A
s. f�r�ewn t`�r- 4k
General description orimprovements4,D�,sl,alM'Z "as
Owner/lessee N
Address 15-gn gljun «UyY1��Il'1et� h
Interest In property: g"Zl���•ey�
Fee Simple Title holder(ifother than owner)
Address
ContractorMI'DCAQ Phone#D-IDL� 3 C) l
Address �I�Q. Fax# ��lc� - J3t� �(D:2
Surety LNa/ Phone#
Address Fax#
Amount of Bond "---
Lender Phone# NO T `
0;00M
m s:m
Address Fax# 0 oar i
0
Persons within the State of Florida designated by Owner upon whom notices or other documents may beserved as provIdg 0 c,
by Section 713.13(a)7.,Florida Statues: a 0 9
Name Phone# v o c=
Address Fax# m c {m
OD-4 X
• In addition to himself,owner designates of o
Phone# Fax# am
0
to receive a copy of the Ldenor's Notice as provided in Section 713.13(1)(b);Florida Statutes. Expiration date of notice!
commencement Is one year from the date of recording unless a different date is specified. WARNING TO OWNER: CD c
ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROP' 0 o
PAYMENTS UNDER CH.713.13,F.S.,AND CAN RESULT IN YOUR PAYING TWICE.FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE 0
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOBSITE BEFORE THE FIRST INSPECTION:IF YOU INTEND TOOBTA �
FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE
COMMENCMENT.
Lessee,or weslfr Lessee's Au omce r/DirectorlPartnerlMttmaged stgnatu�
Signatory's Title/Otaee
i State o ,County of
Acknowledged before a this 1 Z ,day of -SL'- 2O L by ha-ie-LA • UQI I E i
70",
'so
ly ka w o me or who has producedL. DV1]( �cr.t�c as id titivation.
�"Af �fir. eu l
a re oto Type or Print Nape e of Notary (Seal)
Title:N 1 Commission Number o"k9bin a a•
STACEY L.BRUNELL
Notary Public,State of New Yolk
Reg.No.01 BR5078922
Qualifiedin Clinton Co. �
tiAy Commission Expires I