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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 - 2 ® I Permit Number:
91To ILUCllILE 0 1 RECEIVED
O N
,
- ° Building Permit Application NOV 13 2020
Planning and Development Services Permitting epartment
Building and Code Regulation Division Commercial Residential St. u re County
2300 Virginia Avenue, Fort Pierce FL 349,82 ,
Phone: (772) 462-1553 Fax: (772) 462; 1578
PERMIT APPLICATION FOR: iWJ1-1 FL LL C - S
PROPOSEDD IM'PROVEIVI'E'NT:LOCATIO'N:m h „ t'.� .g
Property Tax ID #: 13 O l (go -7 co ge " 0 cp .0
Site Plan Name: LCA lC_eS y0pd
Project Name: W,71-i FL LLCM
DETAILED DESCRIPTION OF WORK:
. ^. _ _
Lot No. ', 2 2
Block No.
New Electrical Meter Second Electrical Meter v r
CONSTRUCTION 1NFO'RMATION: -
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping utters Win ows/Doors _ Pond
�lectric /Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: � �,_L Sq. Ft. of First Floor: u4LP
i
Cost of Construction: $ Utilities: —Sewer Zseptic Building Height: I s )-CTU
OWNER/LESSEE,
CONTRACTOR:
Name 'Y-j<T CM
Name: Mzlt-(�\l�(l�
Address:3pQJ i)e.mrA-t,) L61. , Dr. S+--2.0
Company: w,-Y14 F2 L1-G
City: AJ OrC_!'D S S State: GA
Address: 30011 C-r*Jfr YYS Ll] &_e,IQ-,
city: 1V�Gr p - .,�7 State: G�
Zip Code: 3 00 -71 Fax: L A�
Phone No. 901 a 7 0 Ca L0 ia-ol
Zip Code: 3 O O -7 I Fax: 64V-1
E-Mail:- 40nA:11L-. I)ar11 ur(D.Iren+ww mAyvt,4
5-Phone No 3 ra) a U
E-Mail j!bCc2 aLro QrA.h hYh1-WWCQvM1A) hP-
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License 7'1 G
If value of construction is 2500 or more, 'a RECORDED Notice of Commencement is required. "14 y 7 )
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. \\`�' /
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: i Not Applicable
Name: N4 ) I hQ00]J V,312
Address: 3no aEory16jjaIp> >(�iyP�
City: A n.r hl 'L'y— ! State:
Zip: ) 03L3 a. Phone �� Le `6M 1
FEE SIMPLE TITLE HOLDER: _� Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING OMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
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 Horne 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 lend or n attorney before commencing work or recording vour Notice of Commencement.
Owner/ Lessee/Contractor asl Agent for Owner
STATE OF FLORI,RQA
-COUNTY OF )nMva
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this ;; day of 2020 by
�G�a � �Q I l ►� �
Name of person makin statement.
i
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Pub - f FI'!!�Alli��F1°10
* r. o2owo
Commission No. © E+�Ffi~
Sign a re Contractor/License Holder
STATE OF INDIANA
COUNTY OF HAMILTON
Sworn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
this C @ day of (2CA3 ,, nPl , 2020 by
!r D�- L"A 0 0 14 'L e
Name of person making statement.
Personally Known V OR Produced Identification
Type of Identification
Produced
tb
_ (SigAJture of Notary Public- State of Indiana )
Yvonne M.Senesac
Commission No. 0664315 i;�`�' Hamilton County, IN
My Commission Expires
REVIEWS FRONT ZONING! SUPERVISOR PLANS VEGETATION SEAT' URTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
COMPLETED
SUPPLEMENTAL CONSTRUCTION LIEN, LAW -INFORMATION: -
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: mumemmuip Name:
Address: sdoArooksfde 46 Address:
City: Ammer -State: PA City: State:
Zip: i9opi Plibne 8aR Rnni zip:. Phone:.
FEE SIMPLE TITLE -HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name:- Name:-
Address: Address:,
City: _ City:
zip-.,- Phone:: zip� Phone?
0 - WNER/ CONTRACTOR AFFIDVIT: iApplicatlon is h ' ereby 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.
granting; h e permit'11 Id to build the subject
structure
St. Lucietouri makes no;representationithat is grant* twill-aut orize,th, holder
which is'ih�dqfi%[Ct with dn' WplicabliAbme Owners 00.6tion ruIesj'byIaW&dt.and coventhtsthat may restrict or Ofohibit such
structure .'P,l4As# Uth your Home Owners Association' and reviewbylaws for any r6WIdlons which4hay apply.
V9
In consideration of the granting of this requested permit, Iclo 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
VV ILI I 1IC-_11UGA WI UII ,y W
5SIgn ssee/Contractor as Agent for Owner
gn@
tractor/License'Holcler
CS
5 IDA
TLORIDP).
COUNTY OF 6re_-r e_7711
COUNTY OF
S�wqrn'_to (or affirmed) and subscribed b efore me of
S�w�n to (or affirmed) and subscribed before me of
" Notarization
P s * cal Presence or Online Notarization
12R c a'
4a
Ph! I Presence or Online
v— Ph
this Ljy'd7y'of iv by
this of .2020 by
.2020
Name of person rak7nsia terne'rit.
Name of person maik* statement.
Personally KnownOR Produced Identification
PersonallyKnown7 OR Produced Identification
Type of Identification
Type of Identification
Produced,
Produc0d
(Signa re, ota
(Signature of Notapivwswc-v--
NOWY PYW saw of FWW
IN
C DOAn
Hw=&WZXAMj MM
Commission No.
EXPW-
Comm] i my — . . "" 02WO (Se
MGM M-4
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED I
DATE
T
COMPLETED