HomeMy WebLinkAboutBuilding Permit Application/ NOCAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: .2 .20.2 Permit dumber:
L� �~ i 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) 462-1S78
PERMIT APPLICATION FOR:
Address:
Property Tax 1 D #: qS' 11 - s� 3 - a o a s - 0 vo C� Lot No.
Site Plan Name: &Ilq Block No.
Project Name: a e LDS
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit- check all that apply:
Mechanical
Electric
Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ ztD p C1, a p
—Gas Piping
— Sprinklers
_CShutters _ Windows/Doors Pond
— Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height,:
Name n ►S evJ 5
Address: ao Q-c e c LA
City: e S e e il (-% State: rL
Zip Code: 114S9 Fax:
- 3 L�
Phone No. �S3 v
Name: 1�Lmal"C
Company: COA4 ..l e/" �
Address: � 3
City: ��✓fir _ State:
Zip Code: 3 q 9 y{„ _ Fax: 772- VX /-
E-Mail:
Phone No
Fill in fee simple 4itle Holder on next page ( if different
E-Mail 2 �- rowl
from the Owner listed above)
State or County License e c j 211 C15-0 f ^�
f value of construction k 750n or morn m or:rnonrn ei-i- -; r:, _.: _.1
____ ._ ____ _. ...�. - • .. — .{„III IIc10.G1 I IV] IL {a 1=4u 1Icu.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Name:_
Address:
City:
Zip:
ER: Not APPlicbfeZ MORTGAGE COMPANY�:.
Phone State:
Name:_
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY.
Name:
Address:
Name:
City:
Address:
Zip: Phone:
city:
Zip: Phone:
--,X Not Applicable
State:
4Not Applicable
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 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
with lender or an attorney beforecommencing work or recording our Notice of Commencement.
re of Ow&:sf'/ Le'sseeContractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF--
Sworn to (or affirmed) and subscribed b ores me of f b f�y,
VZi Physkal l resence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Commission No. QRLANDQVA-'QbEZ
Of
sr°i=Rv°v;� NotaryPubl'ic-State18()94M
tommisslon # GG 1898A1
REVIEWS FRNT led
CO ONTER Lr REVIEW
RECEP
HATE
COMP
I
Contractor/License Holder
STATE OF FLORID
COUNTYOF � . L cw
Sworny(or affirmed) and subscribed before me of
L—Ph sical Presence or Online Notarization
this—Uadayof PFE 2BZn by ZL) Z./
Name of person making statement.
Personally Known �OR Produced Identification
Type of Identification _ I
i6ature of Notgry Oub ice- fate of Florida'N' ' �
`�p�° �04 tip��
mmission No. ��So�a e5 eo10 BPS
PLANS I VEGETATION
REVIEW REVIEW
IANGROVE
REVIEW
NOUCF Ob' COMMENCEMENT
Permit No, Property Tax ID No. Ic-1 - 503 -0 d ,:Z
State of Florida, County of St. Lade
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 _ .T� --
General description of improvements �t cl cl ; oZ a p .� y) 1 Y1
Owner/lessee —\a,Ml D, Skc -S-Zeuo5k�
Address I Ce e-r 1,1 J c nS ,e d3 —a C F'- 5 9 7
Interest in property- 0 u� rt -- Y--
Fee Situple Title holder (if other than owner)?
Address
Contractor C 42 4e S1,Phone # 7.Z - Azll,4
Address _��3�j s 4 1 Uet �l Fax # w
Surety
Address �j/ MICHELLE R. MILLER, CLERK OF THE CIRCUIT COURT
SAINT LUCIE COUNTY
Amount of Bond � FILE 11 4820013 021l 6/202104:04:22 PM
OR BOOK 4557 PAGE 766 - 766 Doc Type: NC
Lender RECORDING: $10,00
Address
Persons within the State of Florida designated by Owner upon whom notices or other documents may beserved asprovided
by Section 713.13 (a) 7., Florida Statues:
:Name � _ Phone #
Address Fax #
In addition to himself, owner designates
Phone #
Fax #
of
to receive a copy of theLienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes. Expiration date of notice of
commeno went is one year from the date of recording unless a different date is spedf ed. WARNING TO ONVNER:
ANY PAYNEENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMDTCMAENrARE CO SIDERED LypROPER
PAY.ME TS UNDER CH-713.13, F.S_ AND CAN RESULT IN YOUR PAYING T WICE FOR LMPROVIMENTS TO YOUR PROPERTY. A NOTICE OF
COi4Il1'I£'.NCEMEIT'.HUST BE RECORDED AND POSTED ON TIi£ JOB SITE BEFORE THE FTiW L'NSFEMON. IF YOU WEND TO OBTAII+I
FINAiNCDTa CONSLLT WTrH YOTIR LEN-DER OR AN ATTORNEY BEFORE CX)Z&AdENcING WORK OR RECORI31NG YOUR TiOT10E OF
CONuQAEWCMEN'T. 1�
or Owa er's or Less
Sigatory's ThIdOfSoe
SSBIratRre .
State of Florida, County of
Admowledged before me this day of �� � 20 � � , by Aay) o is personal)iS' haown to na or who has produced iy as identincatioa-
gnatnre of Nola I
r3' Type or Print Name of Notary (Seal)
Title- Notary Public Commission Number �a_ �
�, ;.`{Aµr'a" SIERRAMCGLD26.2021
2°. Notary Public - Sta
y Commissism.G
l y,F 9Tr MyComm.Expires WdothroughNatar