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HomeMy WebLinkAboutprickett app3Q\:,,m-HaJ»s (9 ‘.§"rLuc..l.€.Co.o<‘3 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:Permit Number: 1 'v Vl DE’ Building Permit ApplicationPlanningandDevelopmentServices Building and Code Regulation Division Commercial Residential2300VirginiaAvenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 X CBDG Funding PERMIT APPLICATION FOR: M ////////i///ii }’i//lii”il’/ii/W ii//f’/?’iiriii’//ii//7/iiiiri/,r"WW it’.i’..';.‘l,f.’i///Z.,f;5"://ii/ii’L7////////7.://L/ii/7/7//"V1/:5’VJIVW’-’/iifiil//’//ii i’iii/Li "/1/'/I////ii’/if///ii/‘f’i’i’/i’.i,~_,f1 ..//ii ii iii’w v :»,,z/~',r ~z i /I//////7 I //r//// :M1 L 1.9.7:,47/;/,//:’I / by I!I I W //7/I’,,IL1 ll-II "'/yr '1“ H,‘ ‘,4 1’wl "'1"/‘l /”‘>v“,I’'L ‘'‘‘:I‘‘H ‘m KW"",' ‘ll ’."V’?! .I "Il‘Va‘«‘' I I ’“l 1/»I [IV Wu "ll: ;Ii,’ I/4'!//Y‘ './I II’I‘,“I : '’/li/il/mlli>il 1 ' ,,2 .1’///ii r ""i'~I ‘W’Vi “"1?/Io "/“M Ii‘/'l.«/‘::,>7//iii’; - ll’I/’i/Ml I "r/ ’ Address:3&3 SE 62aA’£3ci.r;i llox Awe Property Tax ID #:3‘-l [Q -‘-530 °O\'-l7 ‘CDO -SSitePlanName: Q\\U©(pcxrlc "ir ii//ii ('41:!/' 1/fyfill ’% i 7l/M/“M 41547 Lot No. Block No..3 2A;m.:\-l- Project Name: /7 II//Ii}/if 7!A'Ii,fl’§‘,/,,‘’ l 74.,/~ii!/7/.’,;%%//£/,/Wi. '’ /or /T L ,, //'‘/’//’v 7'C 1 .7’, _ A"//ll’/.,::r//i,/Mi iii’ fl, ‘/14 / isazililji‘/,/i 1/1 I \~ " iiiiiiii ’3 ’ '1'"~ ifP /ii"./'1'”.-l".*'r‘/l ’ ‘A fr’ i W”4%W ’'l/’ , _/lg’/ii’ "1 1, L/‘VF,‘/"I I ///Ii’/////Z,I M r u,., 'lffi’/{H “Ii///’ " ' / 3’ ,, :'.ii/,7,’//2,//,./i’/47’. 4 .-”’ .11. . “/17 1 i l I i 7» 7 1 v I i’ 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 15$‘! 51 Z:<3 o , /”’/W ;/1. ‘ “W//irv «/7: // Total Sq.Ft of Construction:Sq.Ft.of First Floor: Cost of Construction:S Utilities: _ Septic Building Height: _ Sewer '//‘if1/7/I 1/"~ /,,/,7./,7/fr /1’/’/ 1' Wfl ,; .’”‘ 'ii ,'1,i/i/’/.2’, ;'~;lri’’’:i’" ill ¢ //l‘$’//”ii//;"//I///ii]/my/i’IW//777'?’/////Ill'{{{f”/2%//1’/vi’/v’/ll’777"///’///’ T{\.-$€. Address:3C-D SE’Cfiauo oaE\\\«A-He.» City:3:33:LV cl). ‘ State:_F__L.. Zip Code:S\-l0|_2 3 Fax: Phone No. Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) l Company:on \o_S©NJ..h Q0-omS Address:SP:Nbo I°\'\ll‘oros 3¥ru’<-City:Po-<~\—SQ:L.\lC;J._.State:_§'l— ZipCode:3"L‘\3’3 Fax: 352.§,2.c.#1495PhoneNo (‘Um Q AS<ac.us E- E-Mail State or Countylicense §LC.F‘,;l "1 ll 8 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. /// /gt:I” A /‘ll // I -i I lI (ll hr 1 ’ l//~:/I7 /7”?/if DESIGNER/ENGINEER: 'I./;/i/I I1’!-‘ til’I OWNER]CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. A Not Applicable MORTGAGE COMPANY:A Not Applicable Name:Name: Address:Address:City:State:City:State:Zip:Phone Zip:Phone: FEE SIMPLE TITLE HOLDER:_X_Not Applicable BONDING COMPANY:X_Not Applicable Name:Name: Address:Address:City:City: Zip:Phone:Zip:Phone: I certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie County makes no rewhichconflictswithanstructure.Please consu t applica les,presentation that is granting _a permit will authorize the permit holder to build the subject structureeHomeownersAssociationrubylawsorandcovenantsthatmayrestrictorprohibitsuchwithyourHomeownersAssociationandreviewyourdeedforanyrestrictionswhichmayapply. In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the workinaccordancewiththeapprovedplans,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,consultwithlenderoranattorneybefor,e commencing work or recording your Notice of Commencement. COUNTY OF this;24 day of Sworn to or affirmed)and 0: ubscribed before me of .202A bv §&/Contractor as Agent for Owner STATE OF FLORIDA- zlvlaw ,4 Physical Presence or Online Notarization Personally Known OR Produc Type ofldentification Produced FL Name of person making statement. efilientification I/ _\-(“Y Pl"""o, -""-$1 a‘ if-ll ''.‘i 0*‘? ‘I MELYN BAILER JOSEPH Notary Public -State of Florida Commission #66 247597 My Comm.Expires Aug 9,2022 (Signature of Notary Public-State of Florida) Commission No.Eat’?/Seal) ev 5/20/2 1 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED