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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPI `D FOR APPLICATION TO BE ACCEPTED i \� Date: / S� / 0 �l Permit Number: 1 O v - SCANNED g BY SCANNED SL Lucie County BY Building Permit Application R Planning and Development Services NOV 15 2018 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 ie County, Permitting Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resi ST. L c PERMITAPPLICATION FOR: PROPO fD NPR t UEME�NT LOC*ATI©N: Address: 1 1 FS (I a1A 1 yLe Lkw y Fal"i fi; elwe L 3 vW9 Legal Description: Property Tax lD#: Z�IG3-EGZ_0003-�/C�O�'Z Lot No. Site Plan Name: Block No. Project Name: J 10--4�-2 5-{2C 1 Setbacks Front 6// Back: Right Side: Left Side: r (! _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Electric _ Plumbing _ Sprinklers - —Generator Total Sq. Ft of Construction: % If40, Sq. Ft. of First Floor: Cost of Construction: $ / S G U Utilities: —Sewer _Septic Roof Building Height: Pitch aWN�l /LTE JE CONTRACTOR: Name ff^A f'�4a6 sy Name:• da So^ G41ar IIt, k. Address: 'Zr✓or CoaaAitir Company:�J%G daIIouf-f, City: FOI-/- p;efc-a State: PC Zip Code: 3G/'7 C111 Fax: Phone No. 19el l 3 3 Z f 612 Address: -11 5`,6. F✓�/aleGn e! City: pO/t ST Lu a/c Stater Zip Code: *3%? 13 Fax: Phone No 7%Z—T'i$—f177�( E-Mail: (1)Ty(l1i GcrnajlGdM Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail c a �D� /< r,' .r kol •ao �t State or County License C— 8 G / 2 T F/ 72' If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPP EM TAl •fl STR ON L N 1f INFUR A 10N. DESIGNER/ENGINEER: Name: _ Not Applicable ',MORTGAGE COMPANY: _ Not Applicable Name: Addre94.%'w-' - Address:. - City: YY Zip;,2L 0 i.'4� - hone State: " ... 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 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. Signatu� f her/ Lessee/Contractor as Agent for Owner Signature YC ntractor/License older STAVE OF FLORIDA Lt 1 STATE OF FLORIDA ' , COUNTY OF '�C L�Ct��F, COUNTY OF JC IE The fo_ rgJ'In instr m nt was acknowledge before me this day of 20 by The f99EE��oing instrument was acknowledge before me this � day of �� 20j& by `w(ZAtA (.a Lftw lw b� ', PQQ CROaaa kil AKI Name of person making staterrignt. Name of person making statem t. / Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Identification Type of Identifica ' Produced vil Produced (Signature of Nota (Signature of No a Public- State ofFloridaAREjjS.NIELSEN Commission No. Vblic-State—of—h2�2r' e of FIdGeSlNocary Public Commission No. .- """a'', KAREN S. IRBgvj EN mmission # GG 207484 ExpiresCommission _, _ f Florida- otery Public # GG y Commission �'�nu„a ,m,,,. June 12 2021,_ pares REVIEWS O I G SUPERVISOR PLANS VE ROVE F COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. I ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Permit Number: UN 1 Date- RECENSD J 2 ; 3017 Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Residential Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial %� PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: 1916 N. Dld Vl to hW Legal Description: 1.04 3 oilisid-e Icd�✓rsiar► Property Tax ID #: 24, (not 0003 00017, Lot No. Block No. Site Plan Name: Project Name: a Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF*WORK: y -' Reflaeemef$' o� (ln 4al §ic a bUilA1'hj prevtouSI j remriVtdOnAervuw (�'fm�}�SLC•I+>rl 013 21; V.3DIMal lcuiWnj on eul4irl CQr,crok slab A mono war to e e orme un er ispermit—c ec a aPpY: ❑HVAG �G.asTank H GasPiping Shutters .Windows/Doors, S n lers Generator Roof Roof pitch Electric L�Plu mg P/qk $Q SF V S . Ft. of First Floor: ��1� Total Sq. Ft of Construction: r 15D6• 00 Utilities: /� Sewer Septic Building Height: Cost of Construction: $ , nin/NFR7t KSSEE:' CONTRACTOR ' ( L(.a S7�itf Sll/V/TQS�'/ Name: rvAVnu ,:� i.��.,. Name n 'fRuS${YLv�It NtC- Address: !-QrQS=rWC011a'ye'" Company: City: fy'T VIP.rIC - State: 1'i Addressf: 6a 6 G;;firu5 City: !D utf State: Phone No. Zip Code: 34a�q Fax: 3�g82 Fax: iZ `Ilo�••Q� DZI 2 2-0I Zip Code: E-Mail' Ci Phone No. ne Fill in fee simpl iStle Ho der on next page (if different E-Mail:�WGGC 15125gD from the Owner listed above) State or County License: value of construction is $2500 or more, a RECORDED Notice of Commencement is required. i Name: City: ' State• Zip: _ 2.0 Phone: -------------------- FEE SIMPLE TITLE HOLDER: KYL Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Name: Address: City: Zip: Phone: BONDING COMPANY: Name: _ Address: ZIP: Phone: Not•Applicable Not Applicable I certify that no work or installation has commenced prior to the issuance of a permit. St. is inocon4ict with any applicable 1Ho a Owners Associatipn ru es aby aws of a'ndp covenants that maydrestrict 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 `con&krency review:*rpom 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 Commenceme nt. Q ;Signature of.0yvner/Less,fie/ContractprasA'gentfBrOw er, s • p,STATE OF FLORIDAE OF FLORIDACOUNTY OF S N L Lac' TY OF 57` L•:� 15" The forgoing instrument was acknowledged before me this to dayof_ M!!_1 20 fT by Rachel 1� 't-hop-�.h"� (Name of person acknowledging ) �w (Signatu(e-of Notary Public- State of Florida) . . Personally Known OR Produced Identification Type of Identificatiorp,,Pf`oduced +i'`v`•%:`o• QTHEFUNETHOFWON Commission -No. r. * MYCOMMISSION(kfuF S: Jaduary 2S�20200 -tBoon.o°`O! - Banded Thru BudgetNo6ryBerri[ Revised 07/15/2014 REVIEWS FRONT, ZONING SUPEF COUNTER 'REVIEW 'I `:uFvi INITIALS The forgoing instrument was acknowledged before me this to day of rn14 20 1) by (Name of person acknowledging) (Signature of Notary Public -State of,Florida ) Personally Known '� OR Produced Identification Type of Identificatiip,Z duced Commission No. + MY,COMMISSION11RA999., REVNS IEW V EV EWON I S REV EWLE I M EVIEWVE