HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: 9 0 - UM
RECEIVED
Building Permit Application MAR 21 loll
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie county
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Y
—
PERMIT TYPE:
'angle, Q-m d I re Si d-y ' Cam.
SCANNED
BY
PROPOSED IMPROVEMENT LOCATION:
St. Lucie Coun
Address: 153U Nay l nr1 J)rlve. T n
PropertyTax ID #: `42 L-L4 -Jh�
O i - cnq,5 - Ut t)-c) Lot No. `"I
Site Plan Name:
\U[Illfl�l'T�l►
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Block No.
Additional work to be performed under this permit -check all that apply:
\/Mechanical _ Gas Tank _ Gas Piping _ Shutters ✓Windows/Doors
Electric �lumbbing II _Sprin rs _Generator ✓ Roof Pitch
Total Sq. Ft of Construction: 4q a In S,(sq. Ft. of First Floor. Z� �i 5 N 4)L{ i li
Cost of Construction: $ tlLl 160� . W Utilities: —Sewer Y-Septic Building Height: -)-a rl
OWNER/LESSEE:
CONTRACTOR:
Name MI(Li � Mc larrkr, Mar;Y
h
01
Name: i Jad
?jin
Address:462-'S SW AVPI'IIIG
Company:/1 Z00
City: DQ 1 L_ State: F
Zip Code: 333 Fax:
Phone No. g5L4 - LDgq - 9� 2_4
Address: 44j5 NV\I -R-16 ] Vista B
City: �nrf L1 LG
Zip Code: Ji4q 4?)3
Phone No —I—j Z -�140
Stater
Fax: 772-3116 = 73'J
- 7 22')
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail O d min @ pn Ce.WWhomes.
Cdrn
State or County License CRC
o59 $5q
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.
SUPPLEMENTAL CONSTRUCTIONLIEN LAW INFORMATION:,__,
DESIGNER/ENGINEER:
Name: QEA Inc.
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:3p
nS �Q
Address:
City:State:
Zip: �3415; Phoner3
L
I god- C,GR
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
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 IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LEN12MOR AN A• rORNE BEEORF RECORDING YOUR NOTICE MENCEMENT.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORID/l��,,��
LLLC•(Q
STATE OF FLORIDA
LL
COUNTY OF oft• ,
COUNTY OF s�F. a t,
The forgoing instru ent was acknowledge efore me
this day ri 20Bby
The forgoing instrument w s acknowledge�'d��]before me
this�dayof Apr -I 209by
of
An--I►ef t) �Jarlod, -,
AmrPL.L) oarja D;n
Name of person making statement.
Name of person making statement.
Personally Known _46— OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
17� a
Aiao is, &)
(Signature of Notary Pu lic-State U Florida I
�!:ity/; Pau18S. Breierkk.FF�Y•??
GG030 y
Commission No. �4fbmission F G0030
(Signature of Notary P blic- State of Flgrida� Paola S. Brei
�� Commission GI
ommissionNo. G1s�30$'-L.��
" Expires: September 15, 20
0 - •.gs Expires: September
�' rlinded thin] ARM
noun
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19
•a
ALL APPLICABLE INFO MUST BE COMPr.c"cD FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: I qb-->- Ci4g7
Building Permit Application
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
PROPOSED IMPROVEMENT LOCATION:
Address: ��J3�nCP IVi��/)C)11 1�rtVl',
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
�'CONSTRUCTION INFORMATION: IIII
11HVAC LJ Gas Tank Gas Piping
11Electric Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Shutters Windows/Doors
Generator 11 Roof = Roof pitch
5 Ft. of First Floor:
Utilities: _Sewer ElSeptic Building Heig t: ,?
-OWNER/LESSEE;
CONTRACTOR:
Name
Name:
Address:
Company:
City: State: _
Zip Code: Fax:
Phone No.
Address:
City: State:_
Zip Code: Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
.711
SUPPL�EIVIENTAL',CONSTRCJCTI IEN1AW INFORMATION
DESIGNER/ENGINEER:
Name:
_ Not Applicable
I i SSX•
MORTGAGE COMP N :
Name: F
—Not Applicable
Addre s: AJe n� rr�
b S-aioo
Addr S
City:
Zip: 3 Phone:
State:
City:4�]Im State:_
Zip: - ?, IS N Phone � (ol - QOa - (ocllf J
FEE SIMPLE TITLE HOLDER:
Name:
�A Not Applicable
BONDING. COMPANY:
Name:
X Not Applicable
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 SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND O OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO OF C MMENCEME "
Signature of Owner/ Lessee/Co or as Agent for Owner
Signa ure of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA,
COUNTY OF Sf . L/ c f / e .
COUNTY OF
The fo mg instrumentwas cknowledge efore me
this day 79 20 by
The forgoing instrument was acknowledged before me
this day 20_ by
of
_ of .
AY d mi) kl od 1 /In
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Pall m S AA111h)
(Signature of Notary Public- State of Florida)
(Signature of NotaryPublic-State of Florida
)
um ry
Paula S. Brei
ir
e!k
Commission No. *a�Ya.' �pmmh(pfl I G
OUMnissionNo. (Seal)
Ell plles: September,
5, 2020
„ „s,.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW o
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
I
DATE
COMPLETED
Rev. 2/ //19