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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO BE COMPLETED FOR APPLICATION TO BE ACCEPTED DateJ-11-0-17 -SCANNED Permit Number: Z=WM� BY "-' 41�� St. Lucie County - 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 x Residential PERMIT APPLICATION FOR: Window/door -,4L 7C- F-,4-FION P' ,,ROP.08ED'imp,kbvEMENTLOCATION ,' Address: 76nn S. C),,'-EAN 'Qlz JEN5EN BEAcQ Fz- 3957 Legal Description: ;5MPR-F5-5 COPJ130MIIJIUAA Property Tax ID It: 450 9-0 - (ZOO - OW Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: _ Right Side: Left Side: 1,bET 4iLEq'bEkRIOTION OFf WORK RjE!-mo,iff E,.yis-riN6 'SLIO)A/6 CLZS-5 C156 AA /--rP t- IZPA in 1 IV 6 To JOA7C)z IS T'1NG Flk^rniNe, A -MI) FfZfAmF- IN WALL v%, )-vl-1 vvlriDQvv , APPL)e 15T-il c-C 0 CqNO DR,vA/,cli T 1"S'Dff -r;a fom-j-c iJ F,->c l c; r i 1v cs ld L.L. w*/< CONSTRUCTION' INFORMATION: Actclitional worK to be nertormed under this permit -check allp Fapp-Fy--* 11HVAC Gas Tank E]Gas Piping LJ Shutters -OWindows/Doors 11 Electric ❑ Plumbing []Sprinklers 1:1 Generator ❑ Roof Total Sq. Ft of -�3 ConstructioLln: Sc Ft Sewe of First Floor: � Cost of Construction: $ I., �> 00 - - Utilities: - r 0 Septic Building Height: °OWNERA ESSEE: CONTRACTOR: Name 61npR� C0NAW1-f1A11U,,r7 Name: AM7-NAN CQ)0V-E Address:- 9600 S. ()QEAtJ 1DR Company: CObK>r C,0N5TJZUc:'nQJV? JIVC City: TzN3,-:)J (1FACt4 State: F-L Zip Code: 3Y7,57 Fax:772-7Zi-/,TFY — PhoneNo. 772-22-9-3003 Address: 17-78 PAW. PLAN city: Jg7v3E" State: Zip Code: 1/95 7 Fax: 772- 33V 019IJ Phone No. 772- 53o 0461 E-lVlail:-04P2fssC0"00 0 SeZ4,5cVMAJP�T Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-M a i 1: A14 7-;E: &) e- Do kFoj" Y) �G�i, OWN C - c-cel State or County License: C,6Q62-05?--5 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. Adk 'aSUP,PLEIVIENTA`L"CONSTRUCTION'U�N,LAIN�INFORMA`TION ��,� t � � n` � � � �'�'� � ' �` �k`� ,� ... v.. ki. r,y P L. dl-� y Y.iu n .�..�[ ...i+,.<Faw D 1 r � � dr. r�a,.� ✓ � t .dYr�..'3 b :N' ,� ,. �Y t�� i. :.m",�FA k 4:.. �f DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 permitapplications 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 commencing work or recording our Notice of Commencement. Signature of Owner/Agent/ Lessee Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTYOF COUNTY OF /�A2TJy The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this _day of 20 14 by this /�6' day of 1An Rom- 20 by 1 .4T%A) I CaD&& [[ C. (Name of person acknowledging) (Name of person acknowledging) is LL m % Z / W ( J N N (Signature of Notary Public -State of Florida) (Signature o otary Public State of Florida) _ U o Personally Known OR Produced Identification Personally Known OR Produced Identification r Type of Identification Produced Type of Identification Produced Commission No. (Seal) `?. Commission No. Fr05QgZ2- (Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE A Q COMPLETE INITIALS .SUPPLEMENTALCONSTRUCTION'LIEN LAW INFORMATION: DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: Zip: Phone: State: City: Zip: Phone: State: FEE SIMPLE TITLEHOLDER: Name: _ Not Applicable BONDING COMPANY: Name: _Not Applicable Address: Address: City: City: Zip: Phone: Zip: Phone: 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 commencine work or recordine voLr Notice of Commencement_ Signature of Owner/ Agent/ Lessee Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF rf)ce,k 10 COUNTY OF /lilyQr�y The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of90h 1 . 20 15 by this /r day of JAIyyA_ 20_6 by V'�0.A\P4'3 -c- COi)ez' i4ZAAJ,) COD&& M N (Name of person acknowledging) (Name of person acknowledging) LL m � J y (Signature of Notary Public -State of Florida) (Signature o otary Public -State of Florida) _ 0 Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced R Type of Identification Produced — V. Commission No. 81�C 2.)r)4,py °„Y TAMARA A CR ORnmis n No. F1'-05g9LZ (Seal) f. Notary Public - Stat of Florida g • "e My Comm. Expires J in 12, 2016 :;, a � Commission # EE 207404 "° �� Bonded Through National Notary Revised 07/15/2014 9 v Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS