Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ryf/ �/� Date: SCANNED Permit Number: 0 V -1 ' 03eq BY St. Lucie County gIOZ oMOM j d3s Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 �•v Phone: (772) 462-1553 Fax: (772) 462-1578 Com'hnercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line IVDOUJ #?ROPOS,�D I(VIP O,E E T LOG JO_N, "4s Address: 31(3o lJ I (D 1 F�- Legal Description: 1' �t Property Tax ID9:_ I�4a5-&610- o!5 66O-17 Lot No. Site Plan Name:.. Block No. Project Name:. Setbacks Front Back: Right Side: Left Side: .N-..u<imk a s % ;- « ,ic'�rPratei�r'.i,ki,h P�C +k LEDG tra.aei�#a.xGs?eM�'"r'•*F �, iR nD£ #S Rf +.Y.+•ty it2 'F'r'Gsl Wf'" '!i'`. .4MsK iIrv' 4r'I+ wua'v3 ex l.e r'.%•'1.£iliUi f vh�fVk -t `.f 1 L(Jk(,e GloJdro( wilt kurricurte ia".pacf d0-� xct f i *+ .w } F= <CONTRCJGTION NROf2MATlOf r Yam' fl i{ t w 2 �'� a Yv i ' .awT3y f c �'....d Ye-. {.J' .:.C: FsT�'' a..3r+.'a .w '!� •{yi Acid rtiona wor to pe orme un er t is permit- check a app y: ^e �HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors Electric Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First floor: Cost of Construction: $ I Of �i©• OO Utilities: Sewer E Septic Building Height: OWNER/,LESS C „" 7 -; rOU Y :._e `GONRRAGT�QR? i s � ,,;x.,�. -.- ,. ... , _.`-.,rr�: ,.e ....,^t15d...�... _'n .�_a.- .. ra at. ,c.. »,. (t c-% Name li Name: J &'9_+t Company: NrG��'urC-( F IV "J Ilo Addre s: I O iJ. trni1uJL �Ilti 1p City: O�v f State 1' L - - Andress -3� t- ►Sf:- bD�((.e.� -'�0� - City: :5+u&r+ State:f—L Zip Code: 349 Fax: Phone No. Zip Code: 34ctq4 Fax; 35Y— lU?E E-Mail: Phone No. 33N- (0 1 % Fill in fee simple Title Holder on next page ( if different E-Mail: _ A ut -} a& Kk.Furor(-F(OVJ Yke-f_ State or County License: % 3I I SI Ato 3 from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. r '�pSfi,hYpx�;kt��(IYL(N$yrV YINRliNk'�'€2R`w� rrr33t�� xTMC v�kM: ultbP�,�iPP°,.��.e x£ -..tau DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: _ City: State: Zip: ," Phone _ Zip: Phone: FEE SIMPLE TITLE HOLDER: _ 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 they issuance of permit. Y. Lucie count makes no representation that is granting 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 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 vour Notice of Commencement. Signa ure of 0 er/ Lessee/Contractor as Agent for Owner ignature o Contractor/License Holder STAT • LORIDA ST OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this _ day of 20_ by j this _ day of 20_ by I I Name of person making statement Name of person inakingstatement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced - (Signature ofNotaryPublic- State of Florida ) (Signature of Notary Public- State of Florida) _ Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW .REVIEW REVIEW DATE RECEIVED DATE COMPLETER Rev.8/2/17 T 1�}PLEI�VTaLC05TCtQ3 illgl"U� ' Pk'..+.£' xlkL .�.. y3 ,yxT i. x w.3.« fee.. '.i' ". `,$. -„x .?y �3 Gt DESIGNER/ENGINEER: _ Not Applicable Name: * RMC�N t hi K ��I MORTGAGE COMPANY: Name: i Not Applicable Address: Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: 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 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 lend r or an attorney before commencingwork or recordingour Notice of Commencement. ature o wner/ Lessee/Contractor as Agent for Owner SiFI S=aturentractor/License Holder COUNTYOFOF ORIDA I �'TI0 FL n I 0 COUNTY OFORIDA . . ;'The for oing instru ent was acknowledged before me this ! day of � 2011 by The for oing instr ent was acknowledged before me this lV daY of er 2019 by Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known —4— OR Produced Identification Type of Identification Type of Identification Produced Produced Q n 1 1� (Signatureo of nPu lic-State of :1 ri ) 'nature of Not Pubic -St o i otarypu0licSfa[eofFlori Commission No. a,� l A (HBcu�tIV Public State of Forid TT D%J a Jayne Hall �•}� p :` on aJayne Hall C mission No. 1 O • G 2075 . ( mm�sston G My Commission GG 207585 2y'a pod' Expires 04/15/2022 ---- —� - — off'—Flortes:04H_512022�-� _ _ _ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER— REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED �(tf�f DATE ' COMPLETED ' Rev.8/2/17