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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: J" 3 ' / Permit Number: R E C E I VFF Building Permit Application AUG / 3 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 IMPROVEMENT LOCATION: ---�^ Address: t 2­1 --27-7 Legal Description: tG ►,L�S � G� , l-- J'�" Property Tax ID#: � ''j —To Z. ©f�� , ©00 Lot No. Site Plan Name: Block No. Project Name: tt> �� 1 Setbacks Front Back: Right Side: Left Side: DETAILED ��RIPTION OF WORK: �s CAF:�S- CONSTRUCTION ORM ION: �`J Additional work to be performed under this permit-check all apply: �HVAC Gas Tank Gas Piping Shutters indows/Doors Electric ❑ Plumbing ❑Sprinklers Generator _Roof Roof pitch Total Sq. Ft of Construction: 500 S . Ft. of First F�loor�: 7�1 Cost of Construction: $ 00 Utilities: Sewer L r I Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Name: Address: --3:7 y_X> Company: City: ��-- C � '22�� e: -I& -Address:� C� Zip Code: Fax: City: Stater Phone No. Zip Code: _� ax: E-Mail: Phone No. -7 7Z Z.'7 Fill in fee simple Title Holder on next page( if different E-Mail: from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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 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 1 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. !4�� s Signature o Con ractor as Agent for Owner Signature of ntractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF /77,4-27i ^/ ' COUNTY OF /71,4--f­> 1 "J The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this -:91 day of 20/2by this day of 20 1 -) by (Name of pers n acknowledging 61 (Name of pers n acknowledging) QaA J---/qabina Jadus 'abina Jadusing:-w (Signature of Nota Publi -State of Florida ) (Signature of Notar Publi State of Florida) Personally Known dLRIA.. OVAIM E tbtion Personally Known OR Prod ced Ide ti ication Type of Identifica Type of Identifica c ' ro I STATE OF FLORIDA NOTARY PUBLIC Commission No. , C=m#FF107�1) Commission N F ORI&aV*WI) Expires 7/19/2018 Comm#FF107045 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: e Building Permit Application AUG 0 3 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 IMPROVEMENT LOCATION: Address: 2"1 ,t�by �`� •, t..L Sal Legal Description: Property Tax ID#: �.�;j �� 2 1 ©flB~"' l Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED RIPTION OF WORK: va CONSTRLICTIO ORM ION: � Additional work to be rtormed under this permit—check all tha apply: E1HVAC LEI Gas Tank ❑Gas Piping _Shutters indowsjDoors 11 Electric ❑ Plumbing Sprinklers ❑Generator Roof71�1�oof pitch s Total Sq. Ft of Construction: 5 06 S . Ft.of First��ic f Cost of Construction:$ V 0 DO utilities:Sewer Building Height: _ OWNER/LESSEE: CONTRACTOR: Name Name: Address: V-2 1'3"7 "j> Company: City: Zip Code: Fax: City: -State: L._ Phone No. Zip Code: �Q'C'J ax: E-Mail: Phone No. —7 7-Z � _J_�71A4:�'t Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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 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. s Signature of WbabrAe66se/CoRtractor as Agent for Owner Signature of ntractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 177f1->2-71, - ' COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this ;[ day of , 20/2by this day of /4z,,,,c,-. -f 20 1 -) by A (Name of pers n acknowledging) (Name of pers n acknowledging) "abina Jadusin /_-�gabina Jadu g'' "Known ta Publi -State of Florida) (Signature of Nota Publi State of Florida) / O �►7� tion Personally Known OR Prod ced Ide ti cation Type of Identifica ' rodgSTATE OF FL IDA NOTARY PUBI ICCcrmiMFF107"I) Commission N F,ORI&al) Expires 7/19/2018 Conn#FF107045 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE 34 COMPLETE INITIALS JOSEPH E. SMITH, CLERK HE CIRCUIT COURT — SAINT L COUNTY FILE # 4337333 OR BOOK 027 PAGE 1444, Recorded 08/0 2017 11 :18 :34 AM 9 I NOTICE OF COMMENCEMENT Perm t 1707- �}�, V22�it No._ Property Tax ID No.41�p.4 `(e7 Z mvo I. 0oo 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 -", tt, � 1--f ` Z ' T NU I General description of improvements �A Owner/lessee 5; N , Address Interest in property: Fee Simple Title holder(if other than owner)_ Address Contractor Phone# �'L`� Address Fax# Surety. Phone# Address Fax# Amount of Bond STATE OF FLORIDA Leader 3 UCI COUNTY Tl Address _ ._. TTFft AND CORRECT COPY OF THE Persons within the State of Florida designated by Owner upon whom noticepn%AA - es li'1P3 > ve by Section 713.13(a)7.,Florida Statues: Name Address F x# 2017 R co nab+: In addition to himself,owner designates of Phone# Fax# i to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. Expiration date of notice or i commencement is one year from the date of recording unless a different date is specified. WARNING TO OWNER: i ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CH.713.13,F.S.,AND CAN 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 WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCMENT. 1% xf—y- alL., ZIZ491� Ow Lessee,orOwner'sorLessee'sAuthorindOMeer/Director/Partner/MaoaeerlSigodnre � S aatory's Title/Ocoee State of Florida,County of 4"-bti Acknowledged before me this 1 ,day of u 20 IL,by who is pe ona n to me or who has produced as identification. 1 Signature of Notary Type or P E oN N*jzlr EU (Seal) Commission/GG 119101 ExpireSJuly29,2021 Title:Notary Public Commission Number v4 Fsln Irounnce 8003DS701B