HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
e
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 Residential_
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: D C I,
Property Tax ID #: —0 >j `l --coo 4 Lot No. W
Site Plan Name: -
._ n b 1 •� i 19 Lo MOP1316i Block No. _
Project Name: _ Z`„ J AnQ, JYOLFLr
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters $.Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ �� (1y Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
N
Name:
Keink a d
Address: (Oq0 fru ' 6CL Id
Company: �e$,
7.oL
City: fA� t �'(Y_Q. StatefL.
Zip Code: 3 Fax:
Address: 'l as 3 P1 g Ca
City: Q-co Bip-A00N State:.
Phone No._ � 1�1/-�[J�j(�j
Zip Code: 3L%2U Fax:
E-Mail:
Phone No_ J()2 - S(pI ')qW
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License_ S «-131a8 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:_
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
,City:
Zip: Phone:_
Not Applicable
State:
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Phone:.
BONDING COMPANY:
Name:_
Address:
city:_
Phone:
�C Not Applicable
State:
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 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 IN DBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR IAA I MMENCEMENT: °
Signatf ire of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
The forgoing instru ent was acknowledged before me
this Vl day of U �� 24� by
Name of person making statement.
Personally Known � OR Produ
p
ced Identification
Tye of Identificatio
Produced
ctor/License Holder
STATE OF FLORIDA
COUNTY OF ���/ j ,ram Q I,O�L,
The fprgoing instru nt was acknowledged before me
this � day of 20:� by
n n
Name of person making/statement.
Personally Known V OR Produced Identification
Type of Identification
Produced
Signature of Notail (��t �,f,,F,l��..�dw�`� �l5ignature o of }- u II Sty�}}2 of ��I rl��{{ 11
vAY r'<t► Notary PuLdic State of Florida � �,� w^ t�otaryPLbhc Sta�e oi�l6rida
Commission No. ie t b Mari Ann OM son Mari Ann Commission
GG 2
Commission oi,,, ,, Y My Commission GG 2(�1)
My Commission G 263967 v xpires 1 /01/2022
` ,, sto"A Expires 10/01/2.022 or st
_,iA A. A A
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
RCV. 1.i/i1J
MICHELLE R. MILLER, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 4811668 OR BOOK 4546 PAGE 2708, Recorded 02/01/2021 03:31:00 PM
Permit No.
State of Florida, County of St. Lucie
V
NOTICE "V COMMENCEMENT
Property Tax ID No. _ %0� Gjll ' Q���• ��Q'r�
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
General
Address
Interest in property:
Fee Simple Title holder (if other than owner)
Address
Contractor HBS, Inc. Phone # 772-567-7461
Address 722 3rd Place Fax # 772-778-3514
Surety Phone #
Address Fax #
Amount of Bond
Lender Phone #
Address Fax #
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13 (a) 7., Florida Statues:
Name Phone #
Address Fax #
Tn addition to himself, owner designates of
Phone # Fax #
to receive a copy of the Lienoz•'s Notice as provided in Section 713.13 (1) (b), Florida Statutes. Expiration date of notice of
4.1 s one year from the date of recording unless a different date is specified. WARNING TO OWNER:
ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER
PAYMENTS UNDER CH.713.133 F.S., 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
COMMENCMENT. .—
or Owners or Lessee's Authorized Officer/Director/Partner/1llanager/Signatore
Title/Office
State of Florida, County of .�.L�I(JIl C•l '----� l
Ac yW gEtl befoie`me us ,day of 20 by (.UYLQ V2?GC�
w o is rsonallly kimw.n t or who h s produced V as identification.
Signature of Notary" Type or Print Name gjota7��"•;�`�°"�°�_'°_"`•%'"•�h''='` `e (S�a`
<;.t�+�t� t`lotary Puilic:;t;d.�, of Flond;
Title: Notary Public Commissimz Number + Fig iarrtVM i::"
t. � p,1y Commission
Expires Q'tt2.^,!'A22
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