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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFq MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I -7 Muno0 aionj -IS t PerNumber: mit Date: ( A9 a3NNb'OS ME - Planning and Development5enaces Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 / Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial 1/ Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED;IMPROVEMENT LOCATI.QN- Address: rf� i� c'�crr11 GUL `/ Legal Description: +- PALS It PropertyTaxlD#: r�a3 �o� Lot No. ' Site Plan Name: ! Awt Block No. _5LX'� Project Name: \ t t Setbacks Front Back: —Right Side Left Side DETAILED DESCR[RTION OF vIlORK ' ...��. � ,Y,�,q( �'• ors �(�e -.� �e'�luaca�--(.F�y� CONSTRUC'[ION )NFORMAT[ON� __ � ; _ - ACIditional wor to e e rme un ert is permit— c ec a at app y: EIHVAC ❑ Shutters oWindows/Doors Gas Tank Gas Piping 11 Electric EJ Plumbing []Sprinklers DGenerator _Roof Total Sq. Ft of Construction: �^^ S . Ft of First Floor. Cost of Construction: $ of 09 00 Utilities:USewerSeptic BuildingHei ht P OWNER/[ES5EE >` CONTRAC[OR Name l i-CGZS Name: C 3 Address % 1 Company: 4210 rC ' City: State: Address: Zip Code: 3�FqY' Fax: City: State:_ Phone No. 27p Code: _ 3 Fax• E-Mail: $ ! Phone N� -7 Fill In fee simple Title Holder on next page (if different E-Mail: from the Owner listed_ above) state or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencementis required. IEIVTAL CONSTRUCTfbN UEN lAlftl IL�}F..QfMATIOIv — ENGINEER: Not Applicable I MORTGAGE COMPANY. Not Applicable Name: Address: City: State: Zip: Phone. FEE SIMPLE TITLEHOLDER: _ Not Applicable Name: Address- City: Zip: Phone: Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: City: 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 ermit holder to build the subject structure which is in cony ict with any applicable Home Owners Association rules, bylaws or an � 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 inspectiog. If you intend to obtain financing, consult with lender or an attorney before _ Signature of wner/ Lessee/Agent / STATE O FLORIDA ,{ 1/� COUNTY OF y Th fprgping instrum nth was ackmowle20 before me thi ' ay of --� 20 abY SPATE OF FLORIDA ij�j /yr COUNTY OF f The gp�ng instru entwas acknowledged before me thi�day of 20 �by 77T''-- �.�r�'�, llll � (SignaturJKn- f No It tate of Florida) (Signatur of P7 afy P�t61io a of Florida ) Personal)wn R Produced IdenYfi'imtion Personaly Known oR Produced Identification Type of IdenfificaUoil Produced .Type of identification Produced lrc��1 Commission No. `. FRAMA"A Commission No. Y D FI'tA1N Notary Public - State of Florida Notary Public - Stale of Florida non MKgprrimission Expkes Jan. 8, 2019 My Commission Expires Jan. 8, 2019 REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE COMPLETE INITIALS ALL APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ¢ q Date: r t Permit Number: RECEIV ED AUG 912017 ® _- IC;UnoO alonJ 'IS Building Permit Application �a Planning and Development Services a3NNVOS Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 / Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial V Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III Address: Property Tax ID #: Site Plan Name: Project Name: Setbacks Front �q ��CrS✓!L/7s(Grrf �(CtQ-3 a6ds 00;; CooI Lot No. hid cltS PA w"Y'Y'' -&t i Block No_ r Back -_Right Side: riuu,uvud, wu,n,u uc errunnea unuerms PerMu:—cr OHVAC _Gas Tank [:]Gas Piping 11 Electric 171 Plumbing Sprinklers Total Sq. Ft of Construction: ( S�00 Cost of Construction: $ ( (Of 0I6 . oo Left Side: Shutters aWindows/Doors Generator _ oaf S Ft. of First Floor. _ Utilities: L_ISewer ElSeptic Building Height: Cr77,0- S OWNE1i/LESSEE CONTRACTOR ,F _ Name CU-2 Name: S41 like_ Address: Company: City: r �`e State:_ Zip Code: 3 Fax: Phone No. $I 3- �� 7' �� Address: (). 166X4� City: State: Z, Zip Code -. Ur Fax: Phone No. 'SU / E-Mail:-%ia+^5 Wlc�i r:(�Lva,'I.c ;.w� Fill in fee simpleT'itle 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. ,SUPPLEMENTAL CONSTRUE TIONlLIEN LAW INFQRMATION DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLEHOLDER, _ 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 contlict with any applicable Home Owners Association rules, bylaws or antl 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 workor recordin our Notice of Commencement. s Signatur Contractor/License Holder _ Signat A of Owner/ Lessee/Agen STATE OF FLORIDA COUNTY OF //y V T7 T t/L STATE OF FLORIDA COUNTY OF The forgoing instrument was acknowledged before me this jL dayoff 4,"i . 20 t7by The for oing instrum twos acknowledged before me this 7dayof c t'G/. .20 �by (Name of p n acknowI dgin ) (Name f son acknowI dgingyy IF (Signature of rotariPblic-S toof Florida) �duced (Signature No to of Florida ) Personally Known Identification Type of Identification Produced Personally Known OR Produced Identification Type of Identification Produced Commission No. O FF A 4" ilaryPta t:-State of Florida Commission No.01 R Y D FRAMPTON Nota Public -State of Florida Commission AFF188186 Commission WF188166 Revised 07/ lmy Dbmmission Expires Jan. 8, 2019 My Commission Expires Jan. 8, 2019 REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REYIEVV VEGETATION REVIEW SEATURTLE REVIEW MANGROVE REVIEW DATE COMPLETE O a / INITIALS A