HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLEUD FOR APPLICATION TO BE ACCEPTED
20` Date: \ \ Permit Number:1C\ 13\1G
Building Permit Application
Planning and
ndCodeRegula ion Dices MAR 0 7 2019
Building and Code Regulation Division � J
2300 Virginia Avenue, Fort Pierce FL 34982 T. uag Cou PermlfElnE1
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Res
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Mt><ti
I PROPOSED IMPROVEMENT LOCATION: __ III
Address: S 7 f) 2uc. iLa D ✓ otli sen ►3GaUn VC 3 cf f ! '7
Legal Description: III 3-IS% q I E Lv ndw a UN2,c b!y +k Sir^ Un: t- J-wo (.toF m t. Lucie COL
C I U r+ce a) 01 /c 6
PropertyTaxlD#: k51\-�11-uaaa-aqd-d
Site Plan Name: Charm f.Ci FGrreit
Project Name: Far✓<-V i&c.r 0Q(
Setbacks Front Back: Right Side: Left Side:
Lot No. —I
Block No. ff
I DETAILED DESCRIPTION OF WORK`. III
Co Mla btt2 r`P. "Ov4 L O f a-,K t J ti r i 7 m cx,4e� t( dp W., dv A'c.4_K_ J~
fnJ tF H ru ,w P C. ! (- c.,aih..-r ') Lm A-e--t e&ry C^ r d- m e,-e, %. ro o t .
I, CONSTRUCTION INFORMATION: III
[1HVAC Ii Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction: a -Xx b
Cost of Construction: $ / to , i a U
3as Piping L]Shutters Q Windows/Doors
Sprinklers 1:1 Generator Roof Mil Roof pitch
S Ft. of First Floor: _
Utilities:CnSewer 0Septic
r
Building Height: I G
OWNER/LESSEE:
CONTRACTOR:
Name_Ci9arLer rckrr'41%
Name:_ 00VII&S 6_ )2o-e—
Address:_ 1;-7 +4vc. 12a by-
Company:60J'L 12fA Koo1^C✓S
,
City:l_rlJai+ State: PL
Zip Code: 3Y4S7 Fax:
Phone No.
Address:33L41 rE SIuf-e,r fi,
City: Spa✓y State: PC
Zip Code: 3�F?-7 Fax:
Phone No. Ae 7 — Val %
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: /01?coderce rvu fc�r. Oa +�+�
State or County License: CGC,13d & S 7 `1
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing0work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF TATE OF FLORIDA-
COUNTY OF FLORIDA,N f. LU cJ`c COUNTY OF lbgi kj; ,
The foing instrument was acknowledged before me The fg7going instrument was acknowledged before me
rgo
this lF dayof /UTAr" 2019 by this Lo dayof /14arC A 20L by
ar-L.(—' p4,rrt N
Name of person making statement
Personally Known OR Produced Identification
Type of IdentificatiogL o L
Prndurwl
(Signature of
REVIEWS
Rev. 8/2/17
State of Florida)
JOI(RBan SAVARESE
MY COMMISSION # GG260667
EXPIRES: September 20, 2022
t)OU014i �. %20k2
Name of rs n making statement
Personally Known ^ OR Produced Identification
Type of Identification
(Signature of N P lic- State of Florida)
Commission o. R % JOHN J. SA g
�i f MY COMMISSION # GG2606i
FRONT I ZONING SUPERVISOR I PLANS I VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW