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Home My WebLink AboutBuilding Permit Application I � ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIVE® • Building Permit Application JAN 12 2017 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential ;PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED I,M.PROVEMENT LOCATION ; Address: y L41-k V1 La ice Legal Description:I Mlgt r 14*,*- S+A k L-D+ a0 (D-SL IAC)(Dl M95 -r q,9) Property Tax ID#: a O,:�u b 00 Lot No.�� Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAI LED.DESCRIPTION OF WORK rODf S4 P1k( Kjzi�, re oQA') 4%D Coo 4?_ n SfiA 11 �)O VnA9t,.,- Cool C . 27ci VAr- Arck 5K,n1 le, � C�o(e, :FI�� l e Gt� v�� l h a v�2 Pee l -n!• S-hc�K r.�molt�1 mcn-�- CONSTRUCTION INFORMATION: Adclitional work to be nerformed . under this permit-check all tbal apply: i wo SO 1JHVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors I ,r Electric 0 Plumbingl�D v S rin�lers 1:1 Generator _Roof 12vOD Roof pitch Total Sq. Ft of Construction: 00 ��'�)C S . Ft.of First Floor: Cost of Construction:$ 1',CI bp^ Utilities:Sewer Septic Building Height: ,OWNER/LESSEE:, CONTRACTOR: • Name M �'Ch I e R01!J u K Name:J l --Lrr,_ }IFMO SW) Address: I Y-5� P;nt JoLl L,r1 Company: �l td f1 City: �r�1- Pr-tre-e Stater Address: s O 1V Zip Code:3Lf C1�( rl Fax: City: 20-e+ SS+LU04 2. State: hone No. 'lrl�-� lLa t-04iol 0 Zip Code:e2-4- -I Fax: I E-Mail: Phone No. n1 a~3 y Lf- rl l61 22 Fill in fee simple Title Holder on next page(if different E-Mail: u ✓'oo-Fi co. O from the Owner listed above) State or County License: C If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: (Address: Address: City: State: City: State: Zip: :::Phone Zip: P-hone:_- _ =- 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. II 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 i n 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. IUlf V P&- LL_ x Signatur a Lessee/Contractor as Agent for Owner Signature of on cto /License Holder STATE OF FLORIDAs4 STATE OF FLORIDA COUNTY OF COUNTY OF Cl,� The forgoing,instru ent was acknowledged before me The forgoing instrurqent was acknowledged before me this 13 day of 201a by this day of 26n by (Name of person acknowledging) (Name of person ac nowiedging) I r (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florid ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification � � _ Type of IdentificatWW - — ---- . .Produced CCN�91fe�IVCW40;;'7j'91AZ;r,3 _ Produced PRQULi�7�k77 JL, !ON#FF 160517Commission No. 0517 Commission No. XAtRES'"(ft*16,2018 2018 �ordallote se,w�,00,,, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE 1 COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW (.DATE "RECEIVED ;DATE ` COMPLETED ev. n<o M I - n •� � ! p � htYNEW { 1 .1 + o�`--- •.L S' t 1. G 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. Sign re of Owner/Lessee/ConKractor as Agent for Owner Signat o Cont or/License Holder STATE OF FLORID , STATE OF FLORIDA COUNTY OF �+ L(. t Wu-(��'y COUNTY OF S{• L4[+i 2, The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20 by this l41- day of Ja, 20 l9.by 1 Jf'W_r'W ( • l� 1 / xm (Name of person acknowledging) (Name of person hcknowledging)I (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 Produced Type of Identification Produced (Commission No. (Seal) Commission No. •:�'•:' -CONSTA )PROULX tt ='c MY COMMISSION#FF 160617 Revised 07/15/2014 (407)39M183 FlardsNaftryflarvim.ow REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE t (INITIALS I(��