HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (-0s 0-6
Date: 10 ' —Z • 2.® 2D Permit Number:
C
o
° rw "--. Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: W j-K t—L LLC
p.a-gOSED IMPROVE ENT LOCATION:
Address: �''�O� l.ei1n_! C�Carr�Q� PC(itLi.VGZ.VI�- lei '� a
Property Tax ID #: 1301. w Q S ong-,' Lot No.
Site Plan Name: i.G-UtWC)Od PcLr -- Block No. SLA
Project Name: it TAA EL L L
L
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check.
alit apply:
_Mechanical _Gas Tank _Gas Piping _ Shutters _Wind ws/Doors _ Pond
p.
Vlectric _Plumbing _ Sprinklers _ Generator Roof �"Fitch :
Total Sq. Ft of Construction: 1 �tJ 3 Sq. Ft. of First Floor: Q4o
Cost of Construction: $ 2.c) utilities: —Sewer ZSeptic Building Height: �W
®1N;N E�/LE��S�S;EE:
CbNTRACI"OR:
Name PL LLCJ
Name:
Address 3 G
ormpany: M1T CAI
City: W a.r D S `a State: �2A
Zip Code: 3097 1 Fax: WA
Phone No. Q) al
, -
Address:'' OQQ it[)(
City: NvState:
Zip Code: Q'7 ] Fax:
hone No G (1g(��
E-Mail
E-Mail:
Fill in fee simple Title Holder on next page ( if differen
from the Owner listed above)
State or County License' .' GtS h. :.
n'
if value of construction is 2500 or more, a RECORDED Notice of Commencement is requires.:.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement -is required.
. Y
•jrJ:
'01/ ,f
SUPPLEMENTAL CONSTRUCTION LIEN LAW. INFORMATION:
^MORTGAGE
DESIGNER/ENGINEER: _ Not Applicable
COMPANY: _ Not Applicable
Name: MU1MM&KWP
Address: jai; Brookside -Ave
City: Ambler State: PA
Zip: 19002 Phone (.21s) g4a-Anol
Name:
Address: .
City: State:
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 ana instailation as inoicatea.
certify that no work or installation has commenced prior to the issuance of a permit:
St. Lucie Counttyy makes no•representation that is granting;a permit will authorize,th`e' Permit holder to build the subject_ structure
which is in conflict with ariy 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
•a.l_ 1_�J_— _ �44.�......... L...F— rcrnrAkCrrvinlir hintira of rnmmPnrPi'nPnt.
YVIL1
-- - -
5ignatpr wrier/. essee/Contractor as Agent for Owner
ature of C 'tractor/L(cense Holder
ST ORIDA
S F FLORI
COUNTY OF P)r-t- a
�p
COUNTY OF .vfi rC�i
rmed) and subscribed before me of
or Online Notarization
4this
S n to (or affirmed) and subscribed before me ofesence
hal Presence or Online Notarization
°c}ay of 1V1�,�� 2020 by
thi day of�rn}': 2020 by
1�
Name of person makin ' atement.
tatement.
Name of person mak�ORProduc
Personally Known OR Produced Identification
Personally Known ed Identification
Type of Identification
Type of Identification
Produced
Produced :-
(Signature of No
(Signature of Nota P bl'c- S a •' F o '
<c
_
b Stift o4 NriY�
gal/Y � c �w pt pipes mq5.: a
FHimpy NNfnr
Commission No. - )eta
Commission No. CiN)
4
r [>' YM4 owl* _
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION,
SEA TURTLE
MV NGIkO*E
REVIEW'
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW'
REVIEW,
DATE
RECEIVED
DATE
COMPLETED
N
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.
DESIGNER/ENGINEER:,, _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: t,,Lolhoc(2 ? 12 ,
_
Name:
Address: 3
Address:
City: e'r State: Y
City: N, State:
Zip: tGJ 60--Q, Phone ID, CAOD
Zip: Phone.
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
City:
Address:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie Count nd posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with len_dler or an attorney before commencing work or recording your Notice of Commencement.
re of Owner/ Le a or as Agent for Owner Slgna a of Contractor/License Holder
STATE OF FLORIDQ STATE OF INDIANA
COUNTY OF ie acd COUNTY OF HAMILTON
T
Sw rn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this dayof_0r,+QJjrd/ 2020 by
Name of person mak70R
tatement/
Personally Known Produced Identification
Type of Identification
Produced
(Signature of N
Commission No.
p2o1010
iuiifo Dow at FlaiillIII
"��y0
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
Sworn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
th�?'day of _ C ±'C' 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
_ (Siihature of Notary Public- State of Indiana )
Yvonne M.Senesac
0664315 `""�''-M, Hamilton County, IN
Commission No. --"N � -. Y
NO=? My Commission Expires
SUPERVISOR I PLANS I VEGETATION I SEATURTLE I MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW