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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ( uu 0 iC• "' • " >``° 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) 462-1578 PERMIT APPLICATION FOR: -t � � tt r � ra ,� e ��` r ., Sri ro r do- n rr rs � t ✓• w S '", nt{.Yt d..a d.Y � r. V -, Address: _) GGyf J o T' laf YCfT // Property Tax ID #: 02N 2R Lot No. Site Plan Name: Z.tJt%��Syna, /?�d�/�� iY.- - P�ZZ,ee- Block No. Project Name: cl ey-'17 New Electrical Meter Second Electrical Meter Additional work to be performed under this permit— check all that apply: c/ Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond P Electric /Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq.-Ft. of First Floor: Cost of Construction: $ '?, Utilities: V Sewer _Septic Building Height: ,'y j :t. 1.—I ; y 14d y`�4_p w 4a:' J„ rt am•... Y 1 r Y �i[ {V M 5 n �11 `- SWNiER/LESSEE` aE w, r rr a r , r�F .,u ..:.� j A F"Tlt 1'v Y '7S{�.�t \ f J%31 y 11Vtl I,r�QNTRACT(ORtf i. h a Name &ZSa" ,Y/L-2,0yla.t"C" 5 . Name: Address:.3T o� S. S/•#%%� Company: "� dive City: 4mz 4 ice State: ja Zip Code: Fax: Phone No. Address: cep �• 3' y5 City: 0Gn± � 7';V'/ene _ Stater Zip Code:'Fax: Phone No ZY� E-Mail E-Mail: Fill in fee simple Title Holder on next page (if different ,from the Owner listed above) State or County License%ZI7, 7Z If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. ,� t.1-y+ — -y— Y: ''..•e.'--2 SUP,PiLEME T LrC`ONSTRPUCTI°ONti,LI - �- '-7c `'hr',T t.. ESN L=AWnINF'O,RMA,"IT �, 4".z. x�yi Y �y✓�e i ) :. I �IT�' 2 �; r < �pp ,�� u ��. Y'3 ^-t Ya` l '.>' �Y G {>- �; n �� ,� �8 . 7 d.,x'V 2+'"• i v�.._,>n';.. .q'R_�.4 ��3 ^i` :I',6;:'ut44.21 v�'_fi�:.,., .M���S.Y.kr._ �'F3J'.�i�.N',t1 wl:�+'1....3..L.�.. �.•: L......ic[ri..'�F.:'c",. .t:..uA...�.l.5 d�, a..r�..'�. .R?=v_w..FJ,w.i...i.�2<ra✓in1&�,. MORTGAGE COMPANY: _ Not Applicable DESIGNER/ENGINEER: Not Applicable Name Name: Address: City: ��' s� Lyca�a, Stater City: State: Zip: Phone ;242) S 5l 3-i 3 Z-4 Zip: Phone: FEE SIMPLE TITLE HOLDER: — Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: City: Address: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the worK and MbLdndLIUII d] rl IUR.d LUU. 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 structure. conflict with any applicable Owners Association andrreview your deed for any restrithat t ons which may aprohibit such 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. L 'e Count and posted on the iobsite before the first inspection. If you intend to obtain financing, consult uci y with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this day of 2020 by Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this day of , 2020 by Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced (Signature of Notary Public- State of Florida ) Commission No. (Seal) (Signature of Notary Public- State of Florida) Commission No. (Seal) ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEATURTLE REVIEW MANGROVE REVIEW REVIEWS FRONT COUNTER DATE RECEIVED DATE COMPLETED R-ev--.5/6/20 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Z - 0 5 - 2,020 Permit Number: a 1'1 LI 9 Uo LL1 C LE - D'>�`,---> BuildingPermit Application RECEIVED pp . Planning and Development Services 18 1020 Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Permitting Department Phone: (772) 462-1553 Fax: (772) 462-1578 st, Lucie county PERMIT APPLICATION FOR: A. -}. +•�>S'.n7' t7.. �... NrL � C if tf x ✓<''M JI ti fiL R..:P a h.- rW. ty?At S� PR {y POSED IMPROVEMfENT^L'OCATIONf�p�ra _J �, 1. f._.e.iw.Y.1__ont..u.,.:,.�....,.:.-...._1wa.�,.. 9rS.nM .r.}7_rv...--.-._.vs,-)A F,.=Y+:.. J.{.+;- Address: J ZOO �. iT�' ��✓e��©% /! --_ Property Tax ID #: Z( / -+ O D 60 >" 00 � � Lot No. Site Plan Name: �e �i yle�Sc�r�� . i.%h_l/l✓i fl0/�� >�%'% .�Q. Block No. Project Name: % on New Electrical Meter Second Electrical Meter ir'y r. .rrtr 7�;l t�,`�'.-IDr��. �,-,i�rrti ,>:s r.f:�.:r A, V�) w'.Y g'�rS'��,:-;ice€ t?'Y. y. f.�-\Y r:b �t1w i1'r^ar'�,�f rr._1 `5 e "�''41 a° i �: �rt:• . � � �.} . r•:Yi'-' � i1SM,�'EM d,,: ti= y..,�i'.9(+:R4_! i, l..h.i, .a,i.:21.r,4.,r:.n. us.:_�s?._va{,....A.:;,t��...�..x:ki�..�':h.:y'�ti.(n�.�f.A. r.':'{'4.. �+rr4Y�i.h..Jy.r., �t piw-,� J• �j X 5+.3� w I = 6,. Additional work to be performed under this permit- check all that apply: ill Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond Electric LAlumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: ` 1 G Sq. Ft. of First Floor: %, / 6 V Cost of Construction: $ !', O i� Utilities: aSewer V/Septic Building Height: ikY J i OWNER 311 }{�'.: of CONTRACTOR r s ,LESSEE x r, f i.''i .�. + 3,s.....',..:..,�:?'y:J. Name ,.r�� �i��,�µy✓esP,?_ -Name:-- a� -- -- Address:^ Off}>-`.".-�. �S,�de,P } Company: 11Y!'i City: State:„ Address:5�� City: E�Ce, Stater Cod'e Fax: Phone No. Zip Code: I/ 9S C Fax: Phone No -?7Z `l� 5 E-Mail: Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License ,? elZz 2 3/ 36 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. .II ..'^.�. ,P, 4 .: .. .• r •'}„" .-...'Sk «.•'-?F; !i^. ..SL:.l 1+, a' ; :;i r..y � f{�1 s U ,•� - . ; a 5!�• R � "� �f. � u� ii,� 1 .r ,3^� i11i d �" ,� i7 1M!'Y �•110 1 11� S.GIi I Vf y 5 $ I tJ. , �J +� T//��L�CONSTRUCTION LLEfN,.IA� �W�u ��N.i}OS tr•. �yK§ >'Il9(i�,}��"L .d� i } 7v �a fFf},.U'M1f• 15�{Nf Afiy,.�'�tY,.," � f�'SYMF"u r{s`'S . y".. Aft h kw ��']v` �Y I.."N� i pl ..•i!}r i 3 �: S. P.f i S 1fy.y i '.1 q „Yhu EM•� 1 (rt5 )Y yy,i rr ,r%}S { n ONE, 1 l� h © { } C3 '� } RM��yTr,��y� ;SUPP`•.,aLEME� ��� V4X �.toK F " f�rN., 4a� - _4 .. l�r.:} MORTGAGE COMPANY: _ Not Applicable DESIGNER/ENGINEER: _ of Applicable Name: Address: Address: —� City: state: & City: State: Zip: Phone -2 6 S� Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable 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 instdildl.lutl db itiuit.aLcu. 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 structure. Please consult With your Home Owners AssAssociation c Association andrreviebylaws y ur deed for any restrithat t ons which may alprohibit such 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 our Notice of Commencement. Siei7ature of caner actor as Agent for Owner Si ature ontrac icense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization Physical Presence or Online Notarization 2020 by this day of , 2020 by this day of Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Pro Iced Produce (Si nature u ic- St i ' �.,• R NDA ROMERO ZELAYA (Signat o b ic- State of Florida ) Commission No. f/, Notary Pubic -State of Florida p issicn ; GG 208712 .?a�' ,��A EapivsApr 18, 2022 ;yr i'^•., Bf���NH[1 o4MERO ZEI AYA Commission No. `�,r. No:aw����d s:ateorF�orida cal • •i ateY Bonded oroush Naronal Notary Assn. Q Cc— ^issici + GC 208712 Cc"—. Exp1•es Apr 18. 2022 aec ..c_i- cuv • ary REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW COUNTER REVIEW - REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.