HomeMy WebLinkAboutBUILDING PERMIT APPLICATION_ AbOL f
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: ; 1 - ooacl
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Building Permit Application j DEC )
PlanningondDevelopment5ervices SCANNED 2017
Building and Code Regulation Division BY St EF'"'17 i ING 2300 Virginia Avenue, Fort Pierce FL 34981 ucre i
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x St. t ud ftad dialountvPL
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PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION
. ;. ; i'
=.
Address: ' Kitterman Road - Lf bol W) /l/* I l�
Legal Description: KITTERMAN (PB 55-32) TRACT A (4.852 AC) (OR 4007-984)
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Property Tax ID #: 3415-707-0001-000-0
Lot No.
Site Plan Name:
Block No.
Project Name: Advantage Self Storage
Setbacks Front •Q3 Back: Right Side:41-Ul Left Side:
I
J. DETAILED DESCRIPTION OF WORK:' *.
6round up 9 9�
-CONSTRUCTION INFORMATION:
Additional work to be errormed un ert ispermit-c ee a a f
PP Y� �
CJHVAC ❑Gas
Gas Tank Piping Shutters Q Windows/Doors
Electric 0 Plumbing ❑Sprinkklers ElE
Generator Roof Roof pitch
Total Sq. Ft of Construction: TJ � 0430/
Ito S Ft. of First Floor:
Cost of Construction: $ c _ Utdrtres Sewer Li Septic Building Height:
OWNER/.LESSEE: CONTRACTOR _
ame G I11 Name: Brown, Paul Beynon I
Address: 266 E Jericho Tump1k6Company: PB Brown LLC
P y:
City: Huntington Station State: NY Address: 446 W Plant Street
Zip Code: 11746 Fax: City: Winter Garden State: FL
A ene o w'l - 3^U $-y Zip Code: 34787 Fax: 561-575-1879
1Vl-aal' ?�m� Slu+�}Q(1(iT fY1� C COIi) Phone No.561-348-4805 f
Fill in fee simple Title Holder on next page (if different E-Mail: Permits@aandjpermits.com
from the Owner listed above) State or County License: CBC1259288
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If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
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 our Notice of Commencement.
_ 4n__ �
Signaturd of Owner/ ss /Contractor as Agent for Owner
igna a of Contracto ' ense Holder
STATE OF FLORID �y `ham (^
STATE OF FLORIDA
COUNTY OF l \t � I (�(V 1
COUNTY OF 11
The oing ins pm t w acknowledged before me
The.. rgoing in u ent�edgbefore me
—lb
thi dayof 1 26_a by
this�d c 20
Name f person making 9thtement
Na a of person making statement
Personally Known SC OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identific n
Produced
Produced
(Signature of Notary Public- t t
(Signature of Notary Public -State of Florida )
KART NEVILLE
Commission No. ��"'�"'% NoteryPuhlic-(y(¢loridz
Commission No. (Seal)
_ CommissionIGG 08i945
ErPires Jul 2 ,2021
My Comm.
my C'thmugh Natiowl Notary Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
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SEA TURTLE
MANGROVE
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REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
SUPPLEMENTAL CONSTRUCTIOMLIEN LAW INFORMATION. s
v&0w1ecry cwa111ccn: _ IVU1:HppucaDle MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
City:
Zip: Phone:
UlrvrvCtt/ LUAI I KAILI UK 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 f' S I spection. If you intend to obtain financing, consult with lender or an attorney before
commend H W k10r recording vnur Nntirp of rnmmanrcmcnr
Signature of Co Itrac ' Holder
Signature of OJnJW1 Lessee/Contractor as Agent for Owner
ense
STAE OFC
OF
UTNTYOFFF SDJ DL1���fL
COUNTYOFORISTATE
OrAwelc
The forgoing instr t was ackn wledgeVefore me
The f rgoing instrument was acknowledged before me
this � day of 20L by
'
this day of � 20�} by
a/ l 1, � ,
Ply J
Name of person Ing st to ent
Personally Known ✓
Name of person�naking statement
!
OR Produced Identification
Personally Known 1 OR Produced Identification
Type of Identification
Type of Identification ,
Produced
Produced C
(Signature of Notary PW!dt State of Fleride) tVZv' /1/j
(Signature of Notary Public- State of Florida )
Darlene LeibrocK
Commission No. Notary °°(�ii`
-�paTa pf1S�rtTu, York
Commission No.
County Of Greene
Commission Expires: 04120121)
1 -
` i :� "� NMary PohSc seledFb
%f`
No. Ol EG204353
snanen Lucas
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
S `. e
' e5 t1/2020
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW .
REVIEW
DATE
RECEIVED
E
CODATMP LETED
Rev. 8/2/17
MORTGAGE COMPANY: _ Not Applicable
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
City:
Zip: Phone:
BONDING COMPANY:
Address:
Zip: Phone:
_Not Applicable
wvvlr&nf a.anr I rwL-I vn Atr•Iuv1I : Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that nt4or� work or installation has commenced prior to the issuance of a permit.
St.
Is inoconfliccttawith any applicable lHome Owners tAssociationl ru esabylaws or and covenants that build
oJr 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 t inspection. If you intend to obtain financing, consult with lender or an attorney before
commen ne rk or recording vnur Nntiro of rr,mn,on,on,e..r
Signature of ner/ Lessee/Contractor as Agent for Owner
Signature of Contract' icense Holder
STATE OF L-6RfBA M P.fal ` l- -
STATE OF FLORIDA
COUNTY F 5 ufFO 11L
COUNTY OF (0Q PrfJa E
The for oing instrument was acknowledged before me
this day of 20 to by
The f rgoing instrument was acknowledged before me.
this L day T-P<1 1 ,
of 201b by
I A of Y_
Pka- 13"Wo
Name of person makhlig statement
Name of person making statement
Personally Known P�_OR Produced Identification
Personally Known _�OR Produced Identification
Type of Identification
Type of Identification
Produced n
1�tJrV�--
Produced
` p
(Signature of Notaryublic- State of Floridan
'(Signature of Notary Public- State of Florida I
Darlenetar Lo.br ek
Notary P��{tt}r��li�q�
Commission No. _ s.�r.- of No�NNMrk
l
� � {Ul
Commission No. S
county of Greene
commission EXglres: 04/20/AO:LL
Nohry Public StMe of Florida
No. O•I F-6204353
"n Lug
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATIO
o.n RS II
8a
E
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW .
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
ALLAMICAINE INFO MUST INCOMPLUED FOR APPLICATION TO Of ACCEPTED
IM20Do Fermi number.
Building Permit Application
Phorw(Irn),162-ISS3 FAvarw6 Fort &,,:pn)462.1SI8 commercial X Residential
I PERMYTAPPYCA'17IONFOR: BujUng
Addfftw. WS KMEWN ROAD
Legal De,,Wl,,:XnTEFIWA(PBSSQZTRACTA(4.852AC)COR4007-064)
Property Tax to 0: 3415-707-0001-00" Latin_
Site pun Name; Block No.
project Name, ADVANTAGE SELF STORAGE
Setbacks From Back: RIGht Side; —Left Swe:
DOWN M1.1-OW.WOK
CIHV Gas Tank ']ping Utters OvAndinus/Doors
CIElecerk {{''-''))Gas
Plumb., leld-ts ❑Generate, Elfloof Rwfpfth
T"kJt0fconstructlon: :Ftdf
cost of construction: s- Utaltv. sewer SCOUC BUffdIRIIHzkW—
Name: INELSH, NIANOM
Con,pgnp WELSH COMPANIES
mr.IB1IeTINOTON STATION
Zip Code, 11746 Fix
phone No.
EEMallk
AddU: 364SWEAU GALLIEBLVt)SUITE 104
Clcr. MELBOURNE —sut,i
ZlpW,.j20U Fax 5614M11879
Phone No. 581-348460
Fill intoi, drasde We Nelda on neirkpago (OdIffetent
"nod above)
E-Mall: PERICITSOAAND)FEIVITS COM
Stole or Comet, thornse: CGI01111824
RECEIVED
MAR 3 0 Z018
T. Lucie county, Permitting
MORTGAGE COMPANY:.
T1iti0: �--
im
_Not Appllable
Nacre- NGINEER: � Not Appke le
Name: .
Address:
City:.
ZIP: -
Phox
State:_
.Address:'—�
CRY•
yF:. Phone•
State:
FEE SIMPLE TITLE HOLDER:
Name:
_Not Appllable
BONDING COMPANY:
.Name:
_Not Applicable
Address:
.Address:
CItiq
Cnr
Zip:'
Phone:
Zip: Above:
OWNER/ CONTRACTOR AFRDVIT: Appikedon Nhcreby made to obtain a permit b do thewmkand lestaaitlan a Irdrated.
Iurtltythd W work wimuleaaon has commenced pdm to the Issuarvat of a permit.
(amnIynuake m - U seen a � oa aNe die Mlde tatoWad Ue Impirns awe
NfaedBn wIi"wYa1"ownea.�it 're+ma'nu�t d"'ill uiy'emtMi'e, Yw++areirm"+v&appry�I Reach
In tmWdmratthm ofthe vmpoaottbls mgvMed PamR 1 do better agree that I WWI. In as reepen%pmfmm the woh
In acmrdamm"Ith the approved pat, the Florida PPNdfnq Coda and Sb Lude fmmty AmaldMMtL
The following Wadley permit applications are s empt from undmgYirya full mncungns, review, ra rnaWitmne,
aroessmytlrvputa, twlmmiq Wok 1mm, qPA dN4 careen roomsmd ameuory bsa to anoUmndnieddenrlal uu
VV
�
lei ee
nNN��w/ as Agent lac Owner
Signal a nusttorlakenutalder
wl
�t)7
rr
M
COATEOF •
couNr01Fw;utire
The$1 iwFs
this --
be me
20 by
The s lnsWment was NkMoleda some..
Ihii l.7Aypf mdlL(/1 .IP. `by
�.eg ;k,
V�
EA_,elgh
Named pegen
pt
patetnent-
Nameof pNSonyutmro statement
ofPec
emmnaYtlmown OMteduredltlmlinmUOo
Id
Personally ✓ O0.lrodueed WmeNtcatlon_
Tt'plO dtlrllflnVpA
TypeaeldeMRlntlan
enadY4d.l{'�1.
pymlure m-PuhIICSlale oftbAdwPlA�d/r
p ofNot�srypPu'bp[C-SbtaolFl I 1
Co.missbn no
(Seal)
Com.10on No.
RENEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
RENEW
RENEW
RENEW
RENEW
REVIEW
REVIEW
DATE
RECEIVED
DATE'
COMPLETED
Ray. 8/2/17
arMgn 4FbrOCk
NOEafrY Aubllss
GRE"It" Of WOW Cous"v OF ore'm
Commlmblo fe ibirpt'O�/10I
No.o1f{YWOq
CtaeE. LBnglre
NOTARY PUBLIC
STATE OF FLORIDA
CaRTNdf FF158078
Expires 9/82018