HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED y
Date: i% % SCANNED Permit Number: I / r� 0 � Do"0O^
St. Lucip RECEI ED
Building Permit Application APR 10 2017
Planning and Development Services
Building and Code Regulation Division
2300, trrginio Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x. Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
-PROPOSED IMPROVEMENT LOCATION::
Address: Florida Turnpike Mile Marker 145
Legal Description: 3 1 3 U .ct U From 5 t NS� 9, .�5
7 9,. 3 r �—a Po = a.� d a GL C t�r✓P_ .. C+.c1� c i" E 2. o f -2 b 3 R 4
Property Tax ID p: 3431-M-0001-000-5. Lot No.
Site Plan Name: Block No.
r - -
ProjectName: - pf olz/jop'� URn� Fl2 lJ� �i L�
Setbacks Front -- Back: - 'Right Side:. Left side:
DETAILED bESCRIPTION OF WORK:
1(tw iA iwti N 4-jr(( Sty a, N)(jz_ 9(evrrfiT.L a�V 61/j ec1
(.CONSTRUCTION INFORMATION:,.
IJHVAC L-1 Gas Tank UGas Piping L_I Shutters
Electric Plumbing ❑Sprinklers Generator
Total Sq. Ft of Construction: //y /9.9 S Ft. of First Floor:
Cost of Construction: $ � Od Utilitiest Sewer
QWindow_ s/Doors,
0— Roof Roof pitch
Building Height: 35—a
OWNER/LESSEE:
CONTRACTOR: -
Name
S .. 0: - (-CC
Name: Bryan Vaughn ..
Address:Si01 04 a as Qr-. SQ r 69Q
Company: Creative Sign Designs -
City: 141( ti State:
ZipCode:•331a't• Fax:
Phone No.
Address: 12801 Corn inodityPlace '
City:.Urnpa . state: FL
Zip Code: 33626 Fax: -
Phone No. 813-907-8000 -
E Mail:
Fill in fee simple Title Holder an next page ( if'different .
from the Owner listed above)
E-Mail: Forpermits@aol.com
State or County License: ES-12000639
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
LJ
97�_
SUPPLEMENTAL.CONSTRUCTION LIEN LAW INFORMATION: II
Na
City:
Zip:.
Name:
Address:'
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ✓Not Applicable BONDING COMPANY: "ot 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 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
comiriencine work or recording vour Notice of Commencement. r o ..
as
STATE OF FLORIDA
COUNTY OF
The forgoing Instrument was acknowledged before me
this —day of - 20 _by
STATE,(�1FFLORIDA
COUNN7TYYOF
The f Ding instru it was acknowledged before me
thisdayof%!c�� 20 by
AL
!J
(Name of person acknowledging) (Name of
-(Signature of Notary Public- State of Florida) (Signatur c
J..
Personally Known - OR Produced Identification P ly Know
Type of Identification Produced - Type of Identific
Commission No. (Seal) Commission No.
Revised 07/15/2014
Public- State of
OR Produced Identification
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
R V EW
REVIEW
REVIEW
REVIEW,
DATE
'
COMPLETE .
INITIALS
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name: cnnatianLar4.y
MORTGAGE COMPANY: x Not Applicable
Name:
Address:+Zoo N FaEaral HM
Address:
City: Ba Raton State: FL
Zip:33432 Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
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 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
STATrOF FLORID STATE OF FLO �A��
COUNTY OF qi p_�= COUNTY OF
The f,o�rg,o,ing instr}{m�en was acknowledged before me
this i2P day of N1J4 � . 20 1i by
I
(Name of person acknowledging)
(Signature of Nalfary Public -State of Florida )
Personally Known I/ OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
The forgoing instr men was acknowledged before me
this 1,2? day of 00i I .20 1) by
lA
(Sign V ure of Notgry Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
¢Bgal) STEPHANIE Rj5eis Ion No.
A o
Itii MY COMMISSION # F170898
A743_ IC,T--PHANIE
's MY COMMISSION i
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS