HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUsT BE COMPLETED FOR APPLICATION TO BE ACCEPTED �'(
Date: � 1 3 ( � �i s Permit Number: 1
r c _ _ l`:County,
EIVED
Building Permit Applicatio F3 2019
Planning and Development Services _ ST. LuciPermittir
Building and Code Regulation Division - - -
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: 7j>00 L SCANNED
PROPOSED INPROVEMENT LOCATION: BYel— St -UeiE) Cad iry
Property Tax lD #: 612 -0 08 - f i' o - c" Lot No.
Site Plan Name: Block No.
Project Name:
I DETAILED DESCRIPTION OF WORK: I
AI
I'CONSTRUCTION INFORMATION: ate, I
Additional work to be performed under this permit- check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
>41ectric _Plumng_Sprinklers _Generator
CoW
Total Sq. Ft of Construction: Sq Sq. Ft. of First Floor: -
Cost of Construction: $ 2 7 i (zo
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name' A.4C1K-1, CIJ 464�1 LIZ
Name:'% -1 Lk
Address: `Ic7CJ3 5 I nr)tlwv. t21LrLR i72-
CompA
city:-1 o)- i�.fL - State: L
?i y % �Z Fax:
No. d
Ad LZipCode:
ity:StaPhone
Zip CE-Mail:
Ph
aLids A S�/Zrd/ lN4.inw
Fill in fee simple Title Holder on next page ( if different
the Owner listed above)
E-Mafrom
Stat
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.
1 DZ36
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City: — — -
Zip: Phone:
Zip: Phone:
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 ITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YMR7LENOER ANA1TQRNEY BEFORE RE[ORDING Y011R NnT1rF nF rnmmFNrFmF:wT n
Signature of Owner/ L sse /Contra or as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLOR
STATE OF FLORIDA
COUNTY OF , i t t(ttid
COUNTY OF
The for oing instru t was acknowledge before me
The forgoing instrument was acknowledged before me
this day of � 20 by
this _ day of . 20_ by
ail
r
Name of pbtson making statement. I
Name of person making statement.
/
Personally Known OR Produced Identification !
Personally Known OR Produced Identification
Type of Identific 'on
Type of Identification
Produced
Produced
AA C r----
(Signature of Notary Pu c- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. y"A:> ., KAREj} af�JIELSEN
te of Fldn a=Notary Public
Commission No. (Seal)
ez
y ` Commission N GG 207484
"'�°gym"•-
June 12,
2022
REVIEWS
F
R
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
I
ev.
ICE OF COMMENCEMENT
Permit No. O� l� a'Tax Folio No. 3I 2- ^ 50a - O 607- 000`I
1110.a, - 023
State of Florida County of St. Lucie -
SSA
NNFO
St 4"Cle °UntY
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chap/ter 713, Florida Statutt/es�,
the following information is provii]d,�ed In this Notice of Commencement. {{{`70 0,3 J • ( VJ, a-, ^1�-I VW � r
Legal Df' J IrVU C4-0 A p�rty ( 01 street fl 0,P address aya�i�lable)`�-T � / nq 9 -7 Qr I , I � � (�� I -�4 ei p...�
General description of
Name cJ (A_L;,4
Address
Interest In property:_
Name and address of
Contractors Name:
for the improvement:
titleholder (if different from Owner listed above):
Phone Number:
Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $
Name and address: _ Phone number:
MOM
a36
Lender Name: Phone Number:
Lenders address: F
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Sectit 0 z
713.13(1)(a)7., Florida Statutes: t
Name: Phone Number: U
Address:
iw ^m
In addition to himself or herself, Owner designates of to receive a copy of o o
Uenors Notice as provided in Sectlon 713.13(1)(b), Florida Statutes. X m H
Phone number of person or entity designated by owner:. > c w
UZo 0
Expiration date of notice of commencement: (the expiration date may not before the completion of construction and final payment b r 0 0 0 �,
contractor, but will be 1 year from the date of recording unless a different date Is specified) a w N t;
s =j �YCZ]
WARNING TO OWNER: ANY PAYMENTS MADE BYTHEOWNER AFTERTHE EXPIRATION OF THE NOTICE OF COMMENCEMENTARE CONSIE w tt p
IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR o 7 LL o a
IMPROVEMENTSTO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
INSPECTION. IFYOU INTENDTO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of per ry, lare t I e ea d the foregoing notice of commencement and that the facts stated therein are true to the best of
my knowledge and b lief. )
(Signature of Owner or Lessee, �rrwner's of Lessee's Authorized
(Signatory's Title/Office)
The Iregoing instrurpent was actAowledged before me this day of
Notary Public Stlrte of Ami0a
Chelsea G Andrade
My Commission GG 156343
Expires 1013=021
L91L for
Na of P on Type of authority (e.g.officer,trustee) Party on behalf of whom instrument was executied
Personally known —or produced Identificatiol>�.
[ure of Not lic State of Florida)
Type, or Stamp Commissioned Name of Notary Public) Type of Identification produced