HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INEQ MUST BE COMAt r:D FOR APPLICATION TO BE ACCEPTED I- Q zz
Date: a ZD q Permit Numb n
SCANNED
v BY )`
's St. Lucie County
' -- APR 2 9 2019
Building Permit Appli ation
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie Count
2300 Virginia Avenue, Fort Pierce FL 34982 County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOS_ ED IMPR01/EME-NT LOCATION:
Address:
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name: 1 "t. Ci 1Cr_ 5 tom\ J
DETAILED DESCRIPTION OF WORK:
��CISi aJ l �ii S . &ffI_ EL_ f iDe_ k4eess l E-L
S
CONSTR CTION I FORMATION:
c l i IS
A clitlonal`y,orktobe,performed,underthispermit—checkalltfhatapply-;
b Nlecfianical-Gas,Tank Gas Piping {� ?Sfiljutters Wirido'ws/Doors
AI dig-
e'ctriG -2!�_Plumbing Sprinklers P�?Generator Roof Pitch'
Tatal;5q. Ft of Construction: Sq. FtPof FirsFloor:
Co�it of,'Const�uction: $ �, l-.Chl � LJL Utilities: I atSeweF;� Building Height:
_Septic
it i3 ,t it
COMNERYLESSEE:
CONTR CTOR:
Name
Name: �7 fJ ;
ccmpany�:V1 O 6S Cp aj
Address: � t \f�Cv
City: '�NPt�� State
Address:(13f4�
Zip Code: _'7-_n Fax:
City: J,L,—n State: IPL
Phone No. 5(Dk— � `_� 22Q1._g
Zip Code: Fax:
E-Mail:
Phone No 2 2 Z
Fill in fee simple Title Holder on next page (if different
1 I
E-Mail e 3inz;r W1W L
from the Owner listed above)
State or County License
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRU N LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY:
Name: SS �CxX� Name:
Addresi Sc� �>`� Pca-1 Address:
City: State: City:
Zip: Phone - --132 Zip;--' Phone:.
Not Affable
FEE SIMPLE TITLE HOLD . _ Not Ap licable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: e: Zip: ne:
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 JOB SITE BEFORE THE FIRST INSPECTION..IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE QF COMMENCEMENT."
Signature of Own /Co ctor as Agent f ner
Signature of C 2 ctor Hold
STATE OF FL RIDA
STATE OF FLORI
COUNTY
3,
COUNTY OF
OF
t�`
Th (e o omg instr I,ent�was�acknowledgefi before
th'a� day ofOR by '
'.".".
The f�gping instrument was acknowledged mera
this day 20/ by
8 p?A
g
[n
Joe u
Name of person maKing slat me
Name of making statement. 9 -
peifson
/
Is N 1
Personally Known' OR Produced Identificat is")
Produced
Personally Known OR Produced Identifi
Type of Identification
Type of Identification
+�
Produced
))
�A�4n/Y
V
(Signature ary,Public-State of Florida )
Commissiori No. (Seal)
(Signature of Nt4ry Public- State of Flo ' a )
Commission No. (Seal)
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Rev 2/7/19
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: "t' Z�' 11 �S, Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECEIVED
Building Permit Applicatio APR 2 3 2018
ST. Lucie County, Permltting
Commercial Residential
PERMIT APPLICATION FOR: —',44 47 AA A/.406;
Address:
Legal Description:
PropertyTaxlD#: cZFtl`j
Site Plan Name: SAJNWNP
Project Name: LAa
Setbacks Front ack: Right Side: Left Side:
Lot No.
Block No.
HaaIuonal worK Lu ae perrorme❑ unuer Cf115 per[T]l L—GneGK all LndL apply:
_Mechanical GasTahk _das'Piping _Shutters _+;—Windows/Doors _
.�rElectric iC-Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 3 Sq. Ft. of First Floor:
Cost of Construction: $ 29 1 OC6 . 00 Utilities: _Sewer _Septic Building Height: 5
OWNER/LESSEE:
CONTRACTOR:
Name Kk E
Name':iWfA
Address: IM '-J*TErLS 'M�)
Company:-2 (�IN03
P�R6fl�eQS CyzSt
City: 311P11 State: r�
"Zip Code: c�� Fax:
Phone No. 5CD [ - 34 Lp ' 229 (O
O� Address: i
�1Pon�l
City: 5 L
Zip Code: Z
Phone No '3
State:
tFax:
Z-.,-5eo—1
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail CqT
-,'ni N L- Lcyn
State or County License
12053g1-1
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION
LIEN LAW INFORMOONc
DESIGNER/ENGINEER: _ Not Applicable
Name: , Aar h oob
MORTGAGE COMPANY: of Applicable
Name:
Addr ss:�T�-
Address:
City:
Zip: Phone— 1 —
State:
2Sa1k_i37_4
City: State:
Zip: Phoffien—
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPA • _Not Applicable
Name:
Address:
Addr
City:
y:
one:
Zip: one:
OWN ER/-CONTRACTOR'AFFIDVO 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 dr an attorney before
commencine wank or recordine vour Notice of Commencement_ o
Signature
Signature
STATE OF COUNTY OF ORIDA I i lie: / \ COUNTY OF TATE OF ORIDA
The going instrument was acknowledge efore me- The fo oing instrument was acknowledge efore me
this % day of 20�by this T day of 20�by
� YV V �% 4 Q� N S 6 19Y►'y �r G qr /15
(Name of persol6 acknowled i ) (Name of person cknowledgin )
State of
(Signature of
Personally Known
OR Produced Identification V
Personally Known
OR Produced Identification
Type of Identifi
n
Type of Identification
Produced
Produced
„�KAREN S. NIELSEEN
�Y°` ;State of Florida-Nota2y74
N
;.; $ .,, KAREN S. NIELSEN
Commission No.
s=° �o State cf r�yp8�-Votary Public
Commission No.
_, _ .= a� jsston
on x
My mmission Expire
= ommis�:on A GG 207464
�yy ,,, My commission Expires
, arv.
�•;,°, °�l�° � Jun, 12, 2022
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FRONT-'
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
ZONING„
COUNTER
EVIEW
REVIEW
REVIEW
REVIEW
REVIEW
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