HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONw
AIhAPPLICABLE INFO MUST BE COMPLL-:,4J FOR APPLICATION TO BE ACCEPTED
Date: $3 -1 -• 1 7 Permit Number:
SCANNED
BY
` St. Lucie County �� E I V ED
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- - - Building Permit Application AUG / 1 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort -Pierce FL-34982 - -
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _�_ Residential
PERMIT APPLICATION FOR: z0lf� rn �9 e
Address: lJibiscjs b�! -fL,c 5eg . Qenc(o oAo i SOS 3V7D n/Ryq Sow
Legal Description: 2-313° 51,4/oE 4t 7<Ae 5za &;,d^ R�1 �dr,if SOS
F1 I Cie C& Fr. wt, 3'!4
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Property Tax ID#: /`%23- 80$ ^Oo2?— o00 -g Lot No.
Site Plan Name: Black No.
Project Name: Co l /ids
Setbacks Front Back: Right Side: Left Side:
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@s✓1 o e l L.eT'Cl 1 �5 pMCf oSQo� .
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Additiona wor to a pe orme under this permit- cneCK all tat apply:
_Mechanical _Gas Tank _,Gas Piping _Shutters x' Windows/Doors' .,
k Electric Y_ Plumbing A Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft ofiConstruction" Sq. Ft. of First Floor:
Cost of Construction: $ �� �i� • Utilities: _ Sewer _ Septic Building Height:
Name_kw-rHy `Z. C01 (/rc4 Name: Rot4Att> )CRnw�!{c,J T ij
Address: CO. Rr Z63 Company: KRw t".-,r IC15"i ' %. TA"--
City: -him-i s State: AlY Address: tl56o 5J% Pf:= S• L
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Zip Code: (05-78 Fax: City: (%fL, 8eppk4state:,
Phone No. Zip Code: '3a9(:,V., Fax:
E-Mail: Phone No :Z"( Z-g73 -95`j7
Fill in fee simple Title Holder on next page ( if different E-Mail Cdtl
from the Owner listed above) State or County License Chi C. 623 S
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
COMPANY: _ Not Applicable
Name:
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City State:
Zip: Phone:
BONDING COMPANY:
Address: —
City:
Zip:. Phone:
_Not Applicable
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 our Notice of Commencement.
Signs ure of Ow er/ Lessee/Contractor as Agent fo Vr},,,
Signartulte of Contractor/License Holder
STATE OF FLORI �
STATE OF FLORI
COUNTY OF'^ c',`
COUNTY OF
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The forgoing instruJT�entwas acknowledged before ) x- a
The forgoing instruentwas acknowledge¢l�ef
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(Name of person acknowledging) V
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(Signature of Vary Pu lic-State of orid )
(Signature of Not Public -State of Florida
Personally Known V__'� OR Produced Identification
Personally Known ✓ OR Produced Identification.
Type of Identification
Type of Identification
Produced
Produced
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.7/2014
N
OTICE OF COMMENCEMENT
Permit No. Tax Folio No. o-0 -DUD-?
State of Florida County of St. Lucie
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes,
the following information is provided in this Notice of Commencement.
Legal Description of Property: (and street
General description of improvement: e m Aof
owner information or Lessee 1
Name PL �-
Address 9.0, 8v Z
Interest in property: PJ:,..•^^zf
Name and address of fee simple titleholder (if
Contractor's Name:
Contractor Address:
Lessee contracted for the improvement:
Owner listed above):
Surety (if applicable, a copy of the payment bond is attached):
Name and address:
Lender P
Lender's
Phe Number:
number.
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Persons within the State of Florida designated by Owner upon whom notices or other documents maybe served as provided by Se
713.13(1)(a)7., Florida Statutes:
Name: Phone Number:
In addition to himself or herself, Owner designates of to receive a copi
Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes.
Phone number of person or entity designated by owner:
Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the
contractor, but will be 1 year from the date of recording unless a different date Is specified)
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WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECFION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of
my nowledgeandbelief.
(i ure of Owner or Lessee, or wner's or Lessee's Autherlied Officer/Director/Partner/Manager i SANDRA L BROWN
Notary Public - State of Florida
nato sTi[le/Office Commission#FF996552
(Sig ry ) M Comm. Expires Jun 18, 2020
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t••Yf„� "• Bonded Ibrauah National "Assn.The foregoing instrument was acknowledged before me this �g day of J COLL , 20}�, i _ ,
By as for
Name of Person Type of authority (e.g.officer,trustee) Party on behalf of whom instrument was executied
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d„.,,,, SANDRA L BROWN Personally known —or produced .ldentificatio\ n `�
(Signature of Notary Public - State of Florida) a°a� i.; Notary Public - Stale of - -- _
(Print, Type, or Stamp Commissioned Name of ! a 6 Commlaslon 8 FF 99, ..Type of Identification produced N SA, VQr
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