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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI III _ e--. p -• A IL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Dilte: MANNED Permit Number: (PC� • ®J"10� Sy I@ Dun Ret C Building Permit Application A06 VeD Pi tinning and Development Services 3 1 2016 B !i ilding and Code Regulation Division PE 2 00 Virginia Avenue, Fort Pierce FL 34982 `St &U RMI�/ly P one: (772) 462-1553 Fax: (772) 462-1578 Commercial Ril etS" PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line .:P_kOPOSED IMPROVEMENT LOCATION: glal Description:%P\%,z_% ..n� . Cal -Se.c M �\c cep O'll _Kzllill Pr'III perty Tax ID #: , — !:A\- Lot No. Ill �J SJ1 Plan Name: 1. \\ Block No. Pr ect Name: t26&V_Pl Setbacks Front Back /� Right Sider Left Side: DI�TAILEb DESCRIPTIO'N'OF WO K: CPNSTRUCTION INFORMATION: Additio ork to be ertormed under this permit— check all apply: KSq. Ga k Gas Piping _ShuttersWindows/Doors Plumbing Sprinklers I Generator 11 Roof TonConstruction:+- S Ft. of First Floor: Cost of Construction: $ 000 ' Utilities:li Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: . N A ' Ci Zip P E. Fill fir Ime A Name: NA N'l Company: Add�jss• •�\l ��C� . City: `Ptu" Q, State!;;F�L- Zip Code:`bVlQNRQ) <S Fax: Phone E- III ai1:�S\�it��rw1; \\ dress:,���J �1e�t�j .��iic�. _ y:�e+�gex��e�� �State��, Code:3VggC� Fax: one No. \4ail: in fee simple Title Holder on next page ( if different Ilm the Owner listed above) State or County License: QG©t`3i3`J It value of construction is $izwu or more, a RECORDED Notice of Commencement is required. � ICI I"SUiPPLEMENTAL CONSTRUCTION LIEN. LAW INFORMATION:. . INEER: Not Applicable SIMPLE TITLE HOLDER: ie: ress: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: Not Applicable I BONDING COMPANY: Name: Address: City: Zip: Phone: I e,6,� rtify that no work or installation has commenced prior to the issuance of a permit. Not Applicable St: Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure w ich is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such str' cture. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In lonsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in ccordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. Th' following building permit applications are exempt from undergoing a full concurrency review: room additions, acIessory 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 il�*ovements to your property. A Notice of Commencement must be recorded 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 recordint=_ vour Notice of Commencement. ature of'Owner/ Lessee/Agent 'ATE OF FLORIDA )UNTY OF 7ZN L.y0--, e forgoing instrument w acknowledged before me s day of CnR`rc, 201S'�e_by ame of person acknowledging) Notary Public- State of Florida ) rsonally Known -•"bR Produced Identification oe of Identification fteduced, r4 - _ ,,PJk PC, •, STEL M. HUNTER— ommission No. Notary(��� -State of Florida • * P= Commission # FF 180552 O,��OF Ft `�P .. i g �•����` Bonded through National Notary Assn. Revised 07/15/20' . �.+� s Sign re of Contractor/License Holder STATE OF FLORIDA COUNTY OF CnAcA %4--s The forgoing instrument was acknowledged before me this!P day of CRAec,Nm , 20 \S*_ by �1i1!N e �t\ - �� e . (Name of person acknowledging) (Signature of Notary Public- State of Florida ) Personally Known%..-,- OR Produced Identification Type of Identification Produced : • + �= Notary Public - State of Florida . A �JJJ[ My Comm. Expires Jan 23, 2019 T-. " Bonded through National Not Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW IDATE LOMPLETE i J{INITIALS I Sep ,�3 16 09:34a Fivestarhousing 7722202439 P.1 kLL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I Date: Permit Number: SCANNW dMAREERMEM"MME, MWI BY st, wds COB* , ftn"Mm" 9=99MM; 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 APPLICATION FOR: To Select from dropbox, click arrow at the end of line POSED IMPROVEMENT LOCA Address: \Z2:> .I'st!'L Legal Description:\�_ Lot No. DV:5 Property Tax ID #: Site Plan Name: 1�) s' Block No. Project Name: Left Side: Setbacks Front ) Z::) Back: 1 Right Side: DETAILED DESCRIPTION OF WORK: T CONSTRUCTION INFORMATION: 'ITA a pp y: Additional workto-5e DerformeT unclut -yi KGas Piping El VAC . 11 Gas Tank I❑--]iLJ _Shutters Elwindows/Doors Electric uplumbing oSprinklers Generator 0 Roof Roof pitch Total Sq. Ft of Construction: -2 s Ft of First Floor, Cost of Construction: $ ZCQ Utilities'Sewer F] Septic Building Height'. OWNER/LESSEE: Address: c-41\ IVA City: �'P,4st State: Zip Code:�,��, Fax: Phone No E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR:. . i . Name: Company: Address: oz- City: 4State: -7--i_ __ Zip Code:`3____11'3F `1_k - Fax: Phone No. E-Mail: State or County License'. Commencement is required. If value of construction is $2500 or more, a RECORDED Notice of Sepik 16 09:34a Fivestarhousing 7722202439 p.2 UPPLl MEN AL C'ONSTRUCTION LIEN LAW INFORMATIONt _...... PESIGNERJENGINEER: Not Applicable ame: MORTGAGE COMPANY: � Not Applicable Name: Address i `• �� tom._c-,::- ity: `" , ��\ !�, ��: —�cJ + State: Address: City: State: Zip: -t'. Phone: -� �a`� - =, r�._, I Zip: Phone: -EE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable � Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 11 certify that no work or installation has commenced prior to the issuance of a permit. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure hich is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such ructure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. ie following building permit applications are exempt from undergoing a full concurrency review: room additions, :cessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use DARNING TO OWNER: your failure to Record a Notice of Commencement may result in your paying twice for nprovements to your property. A Notice of Commencement must be recorded and posted on the jobsite efore the first inspection. If you intend to obtain financing, consult with lender or an attorney before :)mmencine work or recordine vour Notice of Commencement. 1 ntractor as Agent for Owner Signature of Contractor/License Holder MATE OF FLORIDA � STATE OF FLORIDA :OUNTY OF , r,. COUNTY OF (' c the ogoing instp=ent was acknowledged before me The forgoing instrument was acknowledged before me this —D day of sty �+ 20 ? by thisQ___Yiay 20 'iby Name of person acknowledging) (Name of person acknowledging) Notary Public- State of Florida ) ,nally Known ✓OR Produced Identification of Identification Produced (Signature of Notary Public- State of Florida ) Personally Known )____ ~ OR Produced Identification Type of ldentific ti o�lur�94 "ar n'o EL AM . HUNTER fission No. -- `"'', NotarRA, - State of Florida Commission Commission # FF 180552 Bonded through National Notary Assn. Revised 07/15/20 " STi...A %1. HUNTER nrr r'.,:: (*46 Florida -� 11 180552 . r s.v ... ... 1-0 9S4 9n14 6 ' ; - Ni. i!.;r.d;•:otaryAssn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW ATE �� OMPLETE it NITIALS I