HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION! TO BE ACCEPTED �^
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Date: f ' S'a„1 5 Permit Number:
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RECEIVED
s, o.L.(.Ni
a - JUN 21 2019
Plusldin►g Permit Application.
Planning and Development Services ST. Lucie Count , Permitting
Building and Code Regulation Division N
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: N a10 e 'V &AA NA6 AA
PROPOSED IMPROVEMENT LOCATION;
Address: I S IL, L-A L 01— &_d t. N-4VAT P' WE ' VL- 54949
Property Tax ID #: I q o7 5- L 9 0- a d MZ LI Lot N
Site Plan Name: Block
Project Name: laot..Lp, VAC'E
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical _ Gas Tank —,.Gas Piping _ Shutters Y Windows/Do rs
✓ Electric J Plumbing ISainklers _ Generator ✓Roof ' Pitch
Total Sq. Ft of Construction: Aq Sq. Ft. of First Floor:
-Cost Gf Construction: $, Rgb i O60 utilities: %/ Sewer —Septic Building Freight: r
OWNER%LESSEE: " `
CONTRACTOR:
Name UESxr--A Ws 6a (k VWL.Av,1%
Address:. 614 _i1 SM,&G Gut _(;LA%4. , Afli. 510H
City: (40N'rA ',MYW S State: FL.
ZlpCode: MI-55 Fax:
Phone No. o?&9 - ?Jib - W IUV
f-i'Jla;l: 1no6��d�sl�es��; 5A 11am"Nt Can
Fill in fee simple Title Holder on next page ( if different
from1he Owner- listed above)
Name:
cornpany: LM
Address: "` ►�V1 ��
City: St-64,9rfth Stat
Zip Code: �;Iwg Fax: `�`% -5 o
Phone No rlrl;2- 5S9 - 5-94.
E-Mail I .'rA
'
FL,
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State or County License C CX1 8; I SCE
j
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement Is required.
I, 1�,�1•y ,YAN
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DESIGNER ENGINEER., •. Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Sm -trk - e-lz w Name:
Address; 1 Address:
City.L State: City: State:
ZiPhone_i"f,2- 53- - b' 1 ` Zip: Phone,.
FEE SMPU SITI F 140LIM •NEE Applicable DONDING COMPANY: .14_ Not Appl Gable
Name:,
Address: Address:
City: city:
Zip: Phone•_.. -- Zip: Phone:
i
OWNER/ CONTRACTOR AFFIDVIT: Application Is hereby made to obtain a permit to do the work and installation is indicated.
I certify that no work or installation has commenced p4orto the issuance of a permit.
S L cffd Count make no rep rp a Cation that Is granting a ermit will authorize the permit holder to build the subject! (tore
w Ic�i is in oni�ilet wit �i any appi ca�le Homd Owners Assoclpation rules, bylaws or and covenants that may, restrict or pr hl�it such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may appi, .
in consideration of the granting of this requested permit, I. do hereby agree that I will, In all respects, perfofrm the work
in accordance with the approved plans, the 51orida Building Codes and St. Lucie County Amendments.
The fullowin$ building perm;!; appilcations are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, wails, signs, screen rooms and accessory uses ta/another non-residential so
„W AiIIINJIM .TO 9WIW.1P; Y011.10 FAILURE TO RECORD A NOTICE OF COMMENCE MiIY RE$ULT iN YdUR PAYINC
TWICt FOR IMPROVOMiENTS TO YOUR PROPERTY. A NOTICE OF COM . EMENT MUST BE RECOR1<iED AND
POSTED ON TMS JOB SITE BEFORE THE FIRST INSPIECXION. IF YOU D TO O AiN FINANCMN , COpIBiJlT
+sa.XAe!si s.s any. AN. ATa!<!►oar ,agr,nuenl 1rm. i7r •OF ice."
slgnature of Owner/ Lessee/Contractor as Ag t for owner
SIg are of ontractor/License Holder
STi�T>lw 4F 1=I,r71Rt A 4
Y.Q.
STATE, F FLOICID►
Q,t
COUNTY OF
COUNTY OF ' n to vow
e f r Ding instru ent was acknowl dge before me
I''
The forgoing Instrument was acknowledged before me
3 by
s day of 2Q by
this day of, j �1rw.� , 20
•f
ma f person making statement,
N/)rjonally
Name of person making statement.
A Known OR Produced Identification
Fersonsily Known_ OR Produced Identification
Type or Idenilftcatign
•ryp of idcritiflcation
Pr ced ,.,,,,,,
Pr used
CP6 o�UA
( sture of'Notary Pu ,, M.FAPC�YNrIrO (g aturo of Notary Publlo• State of to
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=.= g 8510ldi�(;Kili88M M.PAPC
m Ission No. }'` hipmission N ei��
EX� Fobni y 11, 2021 =, • • • COIVRYIiSgltk! P QQ
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'I � Fd6Npry 11,
Dow 111ru tiaau� Pu6No tHgarwdNal 111.
l
REVIEWS FRONT ZONING' SUPERVISOR PLANS VEGETATION SEA.TURTLE MANGROVE
COUNTER EViEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
(�
'
RECEIVED
DATE:
COMPLETED
eV.
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L /E d E665685ELL auoo 'DaVi oaxv 66:6•C 6ZOE"""Unf
i
1"SUPPLEMENTALCON
STRUCTION LIENIAW. WFORMATIOW..,
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: Y%5N1
Name:
I
Address: 1%A4!5 AA-1
Address:
II
City: 'S�ffijl ftvt ::State: V-L
City: State:
Zip: 52qJB Phone 'IM- 599 - CA,*
Zip: Phone:
FEE MPLE TITLE !OLDER. V Not .Applicable BONDING CO-MRAINY: _N& Apbl cable
Name: Name:
Address: Address:
City: Ci I ty:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installatlo'n�as indicated.
I certify that no work or installation has commenced prior to the issa I ance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject, U
II which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or pr tt1hr1bC1ttu;ruech
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may app
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 ai� I d St. Lucie County Amendments.
IIIn
—1 1 30 - � I . -1 1, ---. _ :-- - nAA;44-.,
the fullowing builditig ptervellL applications -..-
dlt:!t:A%=lllV1 lfullf ulluctsullyr2d full %.ulli-ull=llf-y 1cvle".luwlll Quul--t
non-residential se
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to a other non-residential se
"WARNING TA nWNER.' YOUR FAILURE TO RECARD A NOTICE OF COMMENCE MAY RESULT I PAYING
iwiei-,F-D—R—[M-P--R-O-VE"M-ENTS TO YOUR PROPERTY. A iOTICE OF COM NCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU khD TO 9JBTAIN FINANCING, CONSULT II
2 IC�%nWf 1% AM. A-irTrammy. vrvm !MC. TnELD T1 F nF
I-1cma x Harnon
II
:5iinaturi.6f�c�vi6e7�r-7/-.L:6-s��ee/���C���-2ntractor as Agent for owner
Sigh-91-ure of ontractor/License Holder
III
- =W
STATIE 0�-FLCJRIUA-
FLOR"'it
I
COUNTY OF
I
COUNTY OFIII
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _ day of 20 by
this day of, lorvq- 20Jby
nn
II
Name of person making statement.
-Narne of person making statement.
itPersonally
Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Tly of Identification
Produced
P r uced
� �
rA I
I
II
(Signature of Notary Public -State of Florida
ature of Notary Public- State of ll,10#4-)
Commission No. (Seal)
P .. 4ESSICAM.
gt.
Commission N e
I
COMMISSION #GG5
- EXPffl-ES: Feb muiv, 11
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA -TORT E
wyrumuq
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATEII
I RECEIVED
DATE
COMPLETED
ev. 217]19