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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr- ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: IO-d,y — t Permit Number: Sro3 RECEIVED OCT 23 1017 SCANNED Building Permit Application BY Planning and Development Services St. Lucie County 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 PROP'OSED1(ViPROVENIENT'LOCATION,_ _... � _ __. _ __ _.0 •_ �-_._((11_ _ _..._ _._ _ Address: IO 3cl`i -1 Legal Description: Property Tax tolf`. �5�\-5�0� Od0—(j<Sd b Lot No. Site Plan Name:: Block No. , Project Name: V� L z eaa)n C1 x 1 FS Setbacks Front Back: Right Side: Left Side: DETAILED:,DESCRIPTION OFWORK: 00W, 01.3 HOOR PviziseZ P� CONSTRUCTION INFO_ RMATION IIa�i Illona wor to e e rme un er this permit—checka a pp py: Gas Tank OGas Piping _Shutters � Windows/Doors I�JHVAC 11 1 nE Electric 0 Plumbing Sprinklers I-1 Generator Roof Roof pitch Total Sq. Ft of Construction: G 214 4 S . Ft. of First Floor: Cost of Construction: $ yZ1CJ•O0 Utilities :�Sewer ElSeptic Building Height: QVUNER/LESSEE:. CON Name. Name S Address: T"i Company: City: ©R14tJ1>b Stater Address: City: 4�7w N Stater Zip code: 72� Zg19 Fax: Phone No.- (3'7 = LILR — 01 f)a n Zip Code: 1 Fax: E-Mail: 229"�2� Phone No. Fill In fee simple Title Holder on next page ( if different E-Mai CiYYY1 State or County License: L ITi43- 303 5$ from the Owner listed above) If value of construction Is $2500 or more, a RECORDED N tice of Commencement is required. q. L o /s,csv'Z.xvC6.&- can - -- -'— '•...!,.!- caw., �, Ili I UV,- JLY LlwlllvlG aJWIV., _ _- 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 conflict with any applicable. Home Owners Association rules, bylaws or angcovenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. Inconsideration 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 vnur Nntirp of rnmmPnram68t /1 Y/ Signature of Owner/ Lessee/Contractor as Agent for Owner natures f Contractor/License Holder STATE OF FLO91DA yTA7T�OF RMNW 74764 S COUNTY OF COUNTY OF 7R!'/'Art t- The forgoing instrument was, acknowledged before me The forgoing instrument was acknowledged before me this —day of 20_ by this _ day of . 20_ by Name of person making statement Name of personjpaking statement Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification _ Type of identification Type of Identification Produced Produced r (Signature o No ry •, fate OT (Signature of Notary Public -State of Florida) Commission No. (Seal) ". lc rt No. 6f•aL�'NpA f�pSALES y Com Eznires - October 5.2••-8 'Yyn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE _ COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE �%�% RECEIVED DATE 'Af COMPLETED Rev. a/z/v VI 11;3_ 0 5 ZZuc.2ry ..cnr c�.uuv[Crr: of Hppucaole =GAGE COMPANY: t/Not Applicable Names a Name: Address: I 6i iyua 1, kwv ur 9 Address: city r City: State Zip: ��aN�li-' Phone `7-1 2, �,la_3zi3`7 Zip: Phone: FEE SIMPLE TITLE HOLDER: d Not Applicable BONDING COMPANY: Not Applicable Name: 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. .au uuuM rrcme wnsu¢ wrrn your nome tjwners:Nssocianon and review your deed for any restrictions which may apply - In consideration of the granting of this .requested "permit, ; I doherebyagree that I will, in all. respects, perform the work in accordance with the approved plans; the Florida Building Codes and St. Lucie Courity- 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'. your. Notice. of Commencement: V1/ Sig. ureof0 ne" seefContrapxocasAgentfor0wner igna reofGon ctor icense.Fiolder STATE OF Tsxa s STATE OF 7 %45 COLIN OF Wr1a4 r; COUNTY OF A✓/Avtz<, The forgoing instru pent was acknowledged before me this day of�lli L 20L by The forgoing instru ent w s acknowledged before me of ��/(/i this�Q day 20_&.by " d.'r'r•r, ALEXANDRIARANGEL. {N ALEXAiJDRIARANGE (Name of person acknowl p Expires - - July 7, 2018 (Name of person ackn - •< •••taF Expiies July 7, 2018Expires " (Signature of No Public -State of Werida) LXCA (Signature of Nota ubl/ic-State of Tt:,taS " Personally KnownJLOR Produced Identification Personalty Known' OR Produced Identification Type. of Identification - Type of Identification Produced Produced Commission No. (sea]) (seal) CommissionNo.lViTIVOW (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW- REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.