HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
�. LL -LL
t y__.. n
Permit Number:
Building Permit Application
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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENTLOCATION:
Residential
Address: L lv L.) L V-L Q e fcc F t -5 r{J
Property Tax ID q: 3 C B L o 1' (--'Z1 3 -COJ a
Lot No.
Site Plan Name f "P r(C C,-� 4-C 'y'1 5 G It(- (:(� i i� y, 4 Block No.
Project Name: 4(0 P4 . P,iera r—I Zv4V
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit - check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_ Electric _ Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
_ Generator
Sq. Ft. of First Floor:
Windo ors
Roof
Utilities: —Sewer Septic Building Height:
Pond
Pitch
01lUNER EZEE.,
CONTRACTOR:
Name QjllyL� tic, he
Name: T � M.,toa.c
Address: 410 SJ/J 72
Company: �F �,c,•�+ i }ar�< Szivi ea Ll c
City: :-+- Q,1 rtL Stater
Zip Code: k4S Fax:
Phone No. - 0 S
Address: 9gik- CT -
City: S+ Pe J-4 State: r
Zip Code: 33 ) I to Fax:
-ir- itt-t�
Phone No,,
E-Mail�'�,te�-,qwc.Lt2 0101.L2Ll
_
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
,^^�4
E-Mail1._J fLitS I- Lu^ i
State or County License L'Q,(',. 1 3a %O) }-
n vame or consiruccwn ,s [Duu or more, a RELURDED Notice of Commencement is required.
If value of HAVC is $7,500 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: Applicable
_Not
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 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 before commencing work or recording yourNotice of Commencement.
,
Signatur f Owner/ Lessee/Contractor as Agent for Owner
Sigre of Contractor/License Holder
er
STATE ORIDMfr�S
FLORIDA
COUNTYOF
CONTYFUO
Sworn to (or affirmed) and subscribed e o e
Sworn t (or affirmed) nd subscribed befo
Physical Pre{egce or Onlin otarizat' n
thisi� dayof Wl ay
Ph a or OnlineNo
this � day ob� .� f •ZDZ$of
J
person maki statement. N
Name n making statement.0
nmPerso own OR Produc Rli§c fon
za o
Personally Known OR Produced Ideratification
ors
! (cationProduced
Produced
(Signatu of Nota Public -State o r s
" 7-
(Sig ture o otary Public- State o orida )
.
1
Commission No. �-1 "alp" �'
r
Commission No. �9 '� kYY (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
FILE # 4850903 OR BOOK 4595 PAGE 46, Recorded 04/20/2021 01:38:13 PM
PRFPAIII D I1Y
EF)Wit NI Iq)MC SFRVICES Or FLU110A LIC
e416INI( IINATIONAL to N
Sl PE lFHSMING, Fl A3718
Permit Number
Parcel ID Number 30 t¢b>♦ OZ(3:—bbO.Z _
NOTICE OF COMMENCEMENT
State of Florida
County of
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and In accordance with Section 713 13 of the
Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT' _ "
1.Descnpbonoddresrty (legal descnption):-rggtC'-a.( ACd6S &III Cip.�S �G i Cf7 1 37 A- oAe- Y�
a) Street (jmb) Address: _ t4 on -� � �.-, s-� O
2.General description of Improvements:
aS:M Ifg�,r�.y O � (•71 Nnet.J_S
3.Owner Information or Lessee information it the Lessee contracted for the improvement:
a) Name and address: Q i 1 log.( -I— SPi r...1 (�C --ZL prD 5 •. V Ise ➢r r—{- ie c rc e 3y,; 3�
b) Name and address Of fee simple titleholder (if different than Owner listed above)
C) Interest in property:
4.ContractorInformation
a) Name and address: jg h J l•Y14 (oUr ) f-G-�K7e�•i I-iov>.c SG)r v7 L e% C-L c S F Pe- = e 3 3 7 / 4
b) Telephone No.: sgF z_'7'2 g'- 8-810 Fax No (optional)5.Surety (if applicable, a copy of the payment bond Is attached)
a) Name and address:
b) Telephone No.:
c) Amount of Bond:
6. Lender
a) Name and address:
b) Telephone No.
7. Persons within the State of Florida designated by Owner upon whom notices or other documentsmay be served as provided by Section
713.13 (1) (a) 7., Florida Statutes:
a) Name and address:
b) Telephone No.: Fax No.: (optional)
S.a.ln addition to himself or herself, Owner designates wA of
to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes.
b)Phone Number of Person or entity designated by Owner.
9. Expiration date of notice of commencement (the expiration date may not be before the aanpletion of construction and final payment to the
contractor, but will be 1 year from the date of recording unless a different date is specified) 20
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, 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 COMMENCEMENT.
Under penalty of p ury, I adore That have read the foregoing notice of commencement and That the facts slated therein are true to Me best of my
knowledg an b I' f.
(SgnaMeotQmaaL sa Lessee's (Ava,onze IFmllmiraNrclPaMerlMenager) tPinlNmre a. PmsxteS re
�i g lays TNeIgFre)
The foregoing instrumen was acknowledged bef a Ihis _� day of� V (1 20 Z %
by %C (4 Sc tJC, Ae as � m_f (JW i 9�Y (type of aathwty, e 9 otka. trustee, attorney m tad)
for as
(Name of Person) (type of aumain...e.e. onmr. vuslee. aeomey in lad)
1IX (name of party on behalf of Mlom insbumenlwas immled).
Personally Known ❑ ProducedlD ❑ // L��(d$
Type of ID Notary Signature -& d�Z•
Print name
Lisa A VYwdbyw
My Cammoss.,as,on GG i948aa
���.f Eapnes O31282022