HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO, BE ACCEPTED y
DatC: a.�. Permit Number:
IIII — CS�
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Buildin Permit Application'
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Plann��Iing and Development Services 5T. Lucie County, Permitting
Buildiing and Cade Regulation Division .
230Q ivirginia Avenue, Fort Pierce FC34982 -
Pho''e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
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PERMIT APPLICATION. FOR: Aluminum
Legal
Pro peii Tax ID #: � - 501- .0 C7S- 0o1
Site P an Name:
Project Name: cc.w
Setbacks FrontBack: i Right Side:
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Left Side: lZ/
Lot No.5-3 -
Block No.
_ sk&A a.,A a(urw( UAW SCI-e-�h Oct .��C�(�ure �- � � 3Ca S
.. o , s l 6 ��( [ �,q .
Huumi nai worK io,ue eriormeu unuer erns permR cnecK all Mal apply:
VAC Gas Tank alias Piping : _Shutters a Windows/Doors
[JElectric. ❑ Plumbing []Sprinklers 1:1 Generator O Roof . Roof pitch.
Total ti q: Ft of Construction. S . Ft. of First Floor:
Cost of Construction: $ y0o 5o . Utilities: OSewer - Septic Building Height:. .
Nam ! 11 MAdY LQ S Name: ' k C-h &P_I "T &) P_c,j4ACLn
Addr ss: oZ 1'ri i" Company: Pi oyx_ _..�
City:�tUSQo UIQu) State: Address: �,CnSS� Stu
Zlp C lQde: 3( Fax: City: �u✓-i- �-1-. LI.�C c C State:_a,L .
Phona No.Zip Code: Fax:U
E-Mall: Phone No. :3L(L) - g3'33
Fill in fee simple Title Holder on next page ( if. different E-Mail:. a Y�SLi.�L'n VI�LS/d. C�/d�l
u ) ty1C1 ID l0 9 I
from the Owner listed above .State or oun License:
if valqIof.construction.is $25Q0 or more, a RECORDED Notice of Commencement is required.
V .
SUPPLEMENTAL
CONSTRUCTION LIEN LAW INFORMATION,
r y r
DES'
NER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
N a ml:
Do Kim & Assoaates
_
Name:
Address:
PO Box 10039
Address:
City: IX,ampa
State: FL
City: State:
Zip: 33679
Illl
Phone 813.857.99.95
Zip: Phone:
FEE S
,MPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: _Not Applicable
Nami
Address:
Name:
Address:
city: I''
City:
Phone:
LI
Zip: Phone:
Zip: 11
OWNS R/ 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 ICounty 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 actor ante with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The foll ;wing building permit applications are exempt from undergoing a full concurrency review: room additions,
accesso�lrly 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 otce of Commencement must be recorded and poste n the jobsite "
before the first Vfipection. If you jfjfend to obtain financing, consult with Wider or an a r ey before
et come'rMn k or recording ur Notice of Commencement.
Signature oOwner/ Les�e/Cont actor as Agent for Owner Signature ofontractor/LKnse Folder
STATE OF FLORIDA STATE OF FLORIDA
COU NTY OF saint Lucie COUNTY OF Saint Lucie
i
The fo 'going instru ent as acl nowledged before me The for oing instrument was a knowledged before me
this day of L / 20� by this � day of 2011 by
Michae3. Newman Michael J Newman
Name of person making statement Name of person making statement
Personally Known X. OR Produced Identification Personally Known x OR Produced Identification
Type of Identific Type of Identificat'
Pr duced Prod ced
:
I
(Sign III re of Notary Public- State of FI wB Francene New ignat re f Notary Public- State of F rid
i Notary Public Stat Florida
y • My Commission L21434J
,�'Commission No.- (geyExpires 05/23/20 2No. /� rr Francene New a
Cc t' My Commission G 1434
or Expires 05/23/20
I
I III
REVIEWS FRONT ZONING SUPERVISOR PLANS. VEGETATION SEA TURTLE MANGROVE
I'I COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE 'I
RECEIVED
DATECOMPETED
Rev. 8/21y17