HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-1 - wk
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r
Date: Permit Number:
fit• LUcleCOUnty
Building. Permit Application APR 10 2Q97
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: To Select from dropbox, click arrow:at the end of line I�I
PKUPUSLU IMPKUVEMLNT LOCATION'
Address: Florida Turnpike Mile Marker 145
Legal Description:31 a o L46 -,Hpfo <c4F_ C (>F AFC �'I l 1 0 RCi )q nl ( A.
Property Tax ID p: 3431-122-0001=000-5. Lot.Na. _
Site Plan Name: l Block No.
Project Name: (D2�[�R u2n Oi K.C- 1; wz L
Setbacks Front - Back: Right Side: Left Side:. .
DETAILppED DESCRIPTION OF WORK:. i
Xe- -� brl( )CIS ���lr"'%rl/it4�*¢' �Hf/-C RCi MCA am
CONSTRUCTION INFORMATION(
_nuuiuu[1a, wurK w.0e errurmeu under inls permit-CneCK all apply: - -
11HVAC Gas Tank E]Gas Piping LJ Shutters Q Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Tota65q. Ft of Construction: 03 Sc. Ft. of First floor:
Cost of Construction: $ I� �O ad Utilities,. Sewer'❑Septic Building Height:
,OWNER/LESSEE;
CONTRACTOR:
Name
-
Name: Bryan Vaughn -_ - -
_ _ I'
Address: I 1c
Company: creative Sign Designs
City: (Y1 r State: FL
Zip Code:.'ZL�b Fax:
Phone No. -
Address: 12801 Commodity Place
City: Tampa . State:FL
Zip Code:-33626 -- -- -Fax:
Phone No. 813-907-8000
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Forpermits@aol.com
State or County License: ES-.12000639
it vaiue of construction is 52500 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 TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: 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 permitholder to build the subject
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit si
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 1 will, in all respects, perform the work
in accordance with the approved plansi the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concuire.ncy 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 vour Notice of Commencement_ _
Signature of Owner/Lessee/Contractoras Agent for _Xner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this _ day of - . Zo _by
i
(Name of person acknowledging)
(Signature of Notary Public- State of Florida ) '
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
Revised 07/15/2014
•`FLORIDA
OF
The f r i g instrurrijeril was alknowledged efore me
this ay of /!'f/ ,�/7 .20/ by
/I✓
(Name of p rson acknowledging )
(Signature of Notary Public- State of Florida. )
Personally Known Produced Identification
Type of Identification Produced
Commission No.
DEBOUTU.BRUNTON
My COMMISSION # GG 07307
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
Z
INITIALS
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name: clvisuani-angley
x Not Applicable
MORTGAGE COMPANY:
Name:
x Not Applicable
Add ress:1200 N Feda-1 Hwy
Address:
City: Boca Raton
Zip: 33432 Phone:
State: FL
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
x Not Applicable
BONDING COMPANY:
Name:
x Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
ale
I certify that no work or installation has commenced prior to the issuance of a permit.
Ii
St. Lucie County, FL
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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
commencing wcark or recording vour Notice of Commencement. %1
as Agent for Owner
STATE OF FLORID��
COUNTY OF f ii 15 f1
The forgoing instrgment was acknowledged before me
this J�Lhay of Llf�hl 1 20 17 by
(Name at person acKnot
(Signs ure of Notary Out
Personally Known
Type of Identification Prc
Commission No.
Revised 07/15/2014
State
OR Produced Identification
MY COMMISSION
OF Fl.
Y OF
The forgoing instrument was acknowledged before me
this day of 0041 .20 F) by
(Name of person acknoWWdging )
a. `i—
(Signature of Notary ublic-State of Florida )
Personally Known Vl_�_OR Produced Identification
Type of Identification Produced
70898
STEPFIANIE CE
MY COMMISSION # 17089F
FXPInFS Ortotter 2018
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS