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Home My WebLink AboutBuilding Plans OFFICE USE ONLY: DATE FILED: j "I PLAN REVIEW FEE: RECEIPT NO.: 30a PERMIT NUMBER: O�1D - CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED St. Lucie County Building and-Zoning c �� 2300 Virginia Avenue �OR1�P Ft.Pierce,FL 34982-5652 772-462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS: -2. S/D NAME:ef40A0 A,v,O/1 Ar/ll 7X yek SITE PLAN NAME: 3. PROPERTY TAX ID#: 4. LEGAL DESCRIPTION(attach extra sheets if necessary): �9lrlE ,QG,[Ef. — ytifT.Z - JV/3 0 fT 0� T/1.PGT 3,� GEJ.S Gy[v o7 D it 19rD L or E ,30y,�T 4 Q *0 4!�,R 1 Z Ssd'-,?M 5., PLAT 6. PAGE 7. BLOCK 8. LOT BOOK,79,5/3' NO. NO. NO. 9., PARCEL SIZE: ACRES/SQ FT. LOT DIMENSIONS 10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: .�"i✓Sr4cG �i�l�T ,$'��.oy T�'DO TiL !/✓�i.Ot� ��C/ST/N G 11. SETBACKS(ACTUAL) FRONT:BACK: RIGHT: LEFT: _� SIDE SIDE 12. TYPE OF CONSTRUCTION(Check all appropriate boxes) [ ] NEW CONSTRUCTION [EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [.a---COMMERCIAL [ ] INDUSTRIAL [ ] OTHER(SPECIFY) 13. DESCRIPTION OF PROPOSED USE: _wlD Qfti•��--� 14. Sq. Ft./CONSTRUCTION: ,3 a 15. Sq.Ft. 1 st Floor: 16. VALUE OF CONSTRUCTION: $ y The value of construction is used to determine the amount of permit fees to be assessed. St.Lucie County reserves the right to question and/or modify the indicated value of construction if it is demonstrated that the submitted figures are not consistent with similar types of construction activities. If the value is$2500 or more,a RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 .OWNER INFORMATION NAME: ADDRESS: CITY: STATE: ZIP PHONE(DAYTIME): -�46/ email: IF THE FEE SIMPLE TITLEHOLDER(PROPERTY OWNER)IS DIFFERENT FROM THE OWNER LISTED ABOVE,PLEASE FILL IN NAME AND ADDRESS BELOW. a7 � i FEE SIMPLE TITLEHOLD/E�R CL v O� S.GS/,SR/mil G' �A40SP—W& ADDRESS: 1-ko 1 q'sio e- &.ie. uY!a T a 0 CITY: 4C-r STATE: -L ZIP cy'se 9;�'9 PHONE(DAYTIME):CONTRACTOR INFORMATION INFORMATION ST. of FL REG./CERT#: '0-,t-- ST.LUCIE COUNTY CERT BUSINESS NAME: QUALIFIERS NAME: 11/GTOiY ! g5-7.20 vvE ADDRESS:f3/g CITY: T�� STATE: �L ZIP �3�9 PHONE(DAYTIME): ( /3) ?a/- (,027 f FAX Ncrel- J -Zj- aZ ?/ email�/1pr,---,*gW 4P ARCHIT/ENGINEER: ADDRESS: J-/�1-7 W CGi FToy CITY: Z- /�';, 141 STATE: IC2L ZIP PHONE(DAYTIME): ( /3) qS M EXr: / C BONDING COMPANY: ADDRESS: a CITY: STATE: ZIP MORTGAGE LENDER: Jl/J ADDRESS:-- CITY: STATE: ZIP IMPORTANT NOTICE: When a permit is issued and it is,not picked up within 60 days after notification it will be voided and returned to you by mail. AMR CERTIFICATION: This application is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of capacity, if applicable,for the permitted work. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits may be required for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS,.TANKS, AND AIR CONDITIONERS,ETC.,not otherwise included with this building permit application. i The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non- residential use. NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT.WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE TO APPLICANT: AS THE APPLICANT FOR THIS BUILDING PERMIT,IF IT IS NOT YOUR RIGHT,TITLE, AND INTEREST THAT IS SUBJECT TO ATTACHMENT;AS A CONDITION OF THIS PERMIT YOU PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE ATTACHED CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. W-W OT1,XR/CONTRACTdfi SIGNATURE CONTRACTOR SIGNATURE STATE OF FLORIDA STATE OF FLO A �. L COUNTY OF Q2r_ �� -. :v (COUNTY OF The foregoing in trument was acknowleed The foregoing in trument as acknowledge" before me this day of. =C '2%S,by Y before me thiV day o�20QSby who is �z personally E n �_n ,who is personally known to me or who has produced `y�o cn i4 n known to me or who has produced 51 l i Io '391—fcf3 identification. m,Ln O o.'' " as identification. .Np 4,r�pYgly IIIAuu} pOmV . 4.0':c�p� N 7�r� W,ram D0 e- - Si na re `� ``` g of Not �, Si nature of Notary Type or Print Name of Notary Type or Print Name o7otary Commission No. (Seal) Commission No. (Seal) NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THE APPLICATION. I For specific instructions see appropriate permit checklist. i ST. LUCIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT F�OR1�P BUILDING PERMIT SUB-CONTRACTOR AGREEMENT St.Lucie County Contractor Certification Number: State of Florida Certification Number(if applicable): CooW C D,r/ 5�4,r6 Ci20wE ,a7�,yyF.94r✓i iNG co_ arc. have agreed to be the (Company Name/Individual Name) /��G�i�i✓LG� sub-contractor for C//OtvE /LJ,�,y�/F,yc7�,,�,,•� CP -rove (Type of Trade) (Primary Contractor) for the project located at 71y- X'T (Project Street Address or Property Tax ID#) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department i of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV No.004-00) BUSINESS QUALIFIER (Name.of the Individual shown on the Contractor's License) ORIGINAL SIGrATtiRES ARE REQUIRED I i SIGNATURE PRINT NAME DATE Business Name: ef/�_Q rivE /1�i,i^l y�Ac7 vRi yG G4. .I�yC I Address: 13/9- City/State/Zip: 7"�7�'!�� jG. ,3 36D -Z jPhone: email: I OFFICE USE ONLY: PERMIT# ISSUE DATE I i I I OFFICE USE ONLY r B-P #• Q !� SECTION Q TOWNSHIP S RANGED MAP NO. a � ZONING L, LAND USE LOT CVG% TAZ NO. FLOOD ZONE A FIRM MAP# 1ST FLR ELV MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP #OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC LOT OF REC(after LOT SPLIT LOT SPLIT (before 1/90) 1/90) REQUIRED APPROVED 2 f } �,L s. C } 3k`.>r ADMINST LIBRARY PARKS PERMIT VARIANCE IMPACT FEE IMPACT FEE FEE REPORT PUBLIC BLD HABITABLE RADON FEE CODE IMPACT FEE AREA (RADON) SCHOOL GROSS ROAD CREDIT Y N TOTAL ROAD IMPACT FEE IMPACT FEE_ IMPACT FEE DUE SCHOOL CREDIT Y N TOTAL IMPACT FEE r r4 2 j SCHOOL IMPACT FEE POLICE FEE FIRE FEE MISC FEE TOTAL POLICE/FIRE MISC FEES ADDITIONAL Y N SPECIFY _ �T ='` TOTAL PERMITS of ALL REQUIRED FEES • ] f t REVIEWS ZONING ZONING PLANS MISC. VEGETATION SEA TURTLE MANGROVE REVIEWED BY EXAMING / .�� COMPLETE INITIALS010 o s �� to(o INITIALS 0 I - EDWIN M. FRY, Jr., CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY FILE # 2823355 OR B00 2520 PAGE 2785, Recorded 03/29/2006 11:37 AM NOTICE OF COMMENCEMENT Permit No. Property Tax ID No. O� 2- State of Florida County of ST /-r,e-.0 E 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 i Notice of Commencement. Legal Description of property and address if available /1DJne 0,&Xj-r- //N+Ti � N !Y/iT. I , ,Qf T.tgGT .tj.J-- GG,fS b✓Ly a/fT /Jr0 1.fSJE J/�fT- LO•�.2 +¢C�I�OR ?:CS�0=,26�JJ General description of improvements SiV f ri1Gt f�i]O�JyT TOit'iOv B//may iOwner G L. DE SG!BR!ht 6 Address ,%04 /?N64E Owner's interest in site of improvement fCG Sie",gL2 ' Fee Simple Title holder(if other than owner) Address Contractor C/2/WE Phone 9/$ AZ/-iCX.7," Address/3/E' ,Os¢_ 22" « dJ//L Fax# '/E o28'i3 Surety Phone# Address Fax# Amount of Bond A-1..Q Lender /V" Phone# Address lw/4 Fax# Persons within the State ofFloride designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(a)7.,Florida Statues: { Name <:'Lskid t//4G Phone# 772 --� Address 7,0f[ 4N4rZ0 X0. 01S�I 00/4e.'e fe 3ei hy7 Fax# i In addition to himself,owner designates A14 of f Phone# Fax# to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. Expiration date of notice of commencement is one year from the date of recording unless a different date Is specified. Z-)wnV Signature State of Florida,County of Acknowledge efore me is day of L)t:(-' 20�,by hOs peragonatl 1cqown tome or who has produced as identification. Signature of Notary Type or Print Name of Notary (Seal) Title:Notary Public Commission Number �a• 'JF`:`F 014 1AA O"""PIE COUNTY cMy. . HIS TO CERTIFY THAT THIS ISA TRUE AND 00ITtRECT COPY Of THE a; ORIGINAL, ST, LUCIE COUNTY QQ I'J/ji/,,J C 0 U ti t'i St. Lucie County Building-& Zoning 2300 Virginia Ave Oftip Fort Pierce,FL 34982 BUILDING PERMIT SUB-CONTRACTOR SUMMARY I C/10l�✓E /YJ,gNo�fA�v,¢iiy! �. Tiro will be using the following sub-contractors for'the j (Company/Individual Name) project located at 315'4 'Ot�'1/4,4E (Street address or Property Tax ID#) It is understood that if there is any change of status regarding the participation of any of the sub-contractors listed below,I will immediately advise the Building and Zoning Department of St.Lucie County. i St. Lucie County/ Trade-.. Name of Company/Contractor State of Florida License Number" Electrical Plumbing HVAC/ Cp2�t✓� v�iA`rve-i�-G CO, � 3!.s— Mechanical Av� t.✓ ce vW� ��c Os-� s1�6 Roofing I • Gas I I PERMIT ISSUE DATE: NUMBER: