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Home My WebLink AboutBUILDING PERMIT APPLICATIONT-_ ALL APPLICABLE INFO MUST BE COMPLETED FOR A Date: y' I I' �£ANNED � � B '. t. LucieY Count ONEffMVAMMMMMO Building 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 BE /7//- RECF, RF� ication ApR 1 4%I FQ 17r,� 1 StiI St 7,Q .1) PA�. Residential er PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: Legal Description: Jk_) C09 167 f 9 S 99 17 rR i^2 IAJ rZ 51f - r` 79.6 7 Property Tax ID#: /�Z� 7o2 J30o -000 Z Lot No. 'ZO Site Plan Name: `s 22 9 Block No. Project Name: 32Z 3 ifOa Setbacks Front N- A Back: Right Side: Left Side: hid 7�g'LL /Vi �f9 L (/�o o F .CONSTRUCTION tNFORIVIATIO,N;; � Aaclitional WorK to ❑HVAC ff e forme Gas Tank un aer t is perm rt—c ec a ❑Gas Piping apply: Shutters ❑ Windows/Doors _ ❑ Electric ❑ Plumbing []Sprinklers ❑ Generator Roof Roof pitch Total Sq. Ft of Construction: 2l Ft. of First Floor: I Cost of Constructio • tili:ies: Sewer ❑Septic Building Height: City: ? rref<ce. 1 State: L Zip Code: 3V9 Yi; Fax: Phone No. 7 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) Name:, ®A-1 Address: une DR City: Pr B!? L' P State:4L�f Zip Code: g" g 7 Fax: Phone No. e'V-T/ .3_7 c/ R fit/ 1�e' E-Mail: 42!!n% 03,yp State or County License: construction is $2500 or more, a RECORDED Notice of Commencement SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGN ER/ERGIN`ErR- Name: E / 1!`-1 _ Not Applicable MORTGAGE COMPANY• Name: 4 1 A _ Not Applicable Address: Address City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLE HO DER- Name: _ Not Applicable BONDING COMRArdy: Name: Not Applicable 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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in con ict 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 fir spection. If you intend to obtain financing, consult with lender or an attorney before commenck or recording vour Notice of Commencement,----) 4� 1 eA Sig a ure of Owner/ Lessee/Contractor as Agent for Owner _SigniKure of ontractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ��1ctif / P COUNTY OF SYG'cC/ The fo/Cgoing instrument was acknowledged before me this �r� day of .'Ppj) L 20,by The forgoing instrum t was acknowledge efore me this4 of � 20 y eloG eR C 13,4CD,0J &egt L PAcaeJ Name of person making statement Name of person making statement Personally Known �0 OR Produced Identification Personally Known �OR Produced Identification _ Type of Identification Type of Identification Produced Produced V r otaryPublic- tate lorida) (S otary Public- Stale lorida ) DEBO Commission No. r Commission No. � VN HRAE W 115296 G ExpYeeJuMt 1021 gib, � �. � 9 e� F.�heaJuro15,2021 Mfg B�!17+011NBW�A6�tlryQarltq '�ornd'' mmam.e�x Ontoes REVIEWS FRONT ZONING SUPERVISOR P S VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW W REVIEW REVIEW REVIEW DATE RECEIVED DATE /i COMPLETED /g• Rev.8/2/17 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Dater %a,, 13 Permit Number: RECEIVED Building Permit Ap licati'n� Planning and Development Services TV 13 2017 Building and Code Regulation Division Permitting Department 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial SWWft%County, FL PERMIT APPLICATION FOR: IpRr1PrlSFll INPRn\/FMFNT 1 f1C'�TICIIU• - ,"` ) Address: ? 1" Legal Description: Property Tax ID #: 1 `1a� "1d— 13aa- aad - a Lot No. Site Plan Name: Block No. S g Project Name: Setbacks Front Back: Right Side: Left Side: {" DETAILED'DESCRIPTION OF WORK:" { CONSTRUCTION INFORMATION; � ' . � _ { _Mechanical _ Gas Tank _ Gas Piping _Shutters _ Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: J 100 Sq. Ft. of First Floor: Cost of Construction: $ + Utilities: —Sewer _Septic Windows/Doors �f Pitch Building Height: OWNER/LESSEE:- CONTRACTOR: Name 1^f AncCXO �avier Q-a rt Name: Address:6&0 GPI;. r:ic CriVi\/1-, Lo9*rAFL Company: City: tv.�O-IVWA State:FiG Zip Code: YWz Fax: /`^GI � SJS—/�/36 Phone No. S\\�/ S ' ��i SU Address: City: State:_ Zip Code: Fax: Phone No E-MaiL(/ --� iv�vTYCc/S�VI i5� rD T C° 10V . ((Y, Fill in fee simple Title 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 CONS? RUC7110 LIEN LAW INFOWATION; °. r DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address:- 4»• „ t;= w _ r» ._�'. Address: City: "' ", ` " ' ?a ' i 'J(� ,'» i State: City: State: Zip: -Phone Zip: Phone: FEEiSIMPLE ThE HOLDER: Not Applicable — BONDING COMPANY: Applicable I Name: Name: _Not Addressi"" f : Address: City, City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain'a permitto 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, accessoy 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 Own essee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA I STATE OF FLORIDA COUNTY OF iSk ..L ut \P, COUNTY OF The forgoing instru nt was acknowledged before me The forgoing instrument was acknowledged before me this day of Nd`i 20n by this _ day of .20_ by Ftai\•c.\5ce,2 Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identi?ation Type of Identification Produced L l Produced a (Signature of Notary ublic- S s (Signature of Notary Public- State of Florida ) �Ngr�1pR1E 6. Commission AssloN . :.i6y �p� 022023 ?5 m dd�ggl3ozo Commission No. (Seal) '' i+F EXPIRDe�m d .fO V4 PubtoUndem��rs .. c ondedihm „or REVIEWS ONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.