HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-All APPLICABLE 1111 MUST BE COP TEWOR'A13PLICATION TO BE ACCEPTEI
Date: 1 Permit Number:
Building Permit ApplicatiNCiEVED
Planning and Development Services SCANNED SEP 2zcte
Building and Code Regulation Division -BY
2300 Virginia Avenue, Fort Pierce FL 34982 �t ' I�•P� ty, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 68fi 1T2�8� poiat &RobI
PERMIT APPLICATION FOR:
Address:
Legal Description:
Property Tax ID#: `q0A- C000` 00,;LA-QS`(:)-0 LotNo.VO-3�7
Site Plan Name: / Block No. 57
Project Name:
4etbacks Front �a� IOD Back:JJN,.qdRightSide: +ILeftSide: 30,53
I UUILIjGllm WU1K LU uc Pl 11U1lllcu ullucl �I I1D r1C 11111�—bIICLR tlII Uldl tlrl�.11 Y.
V/ chanical _Gas Tank _Gas Piping _Shutters windows/Doors
Electric Plumbing 1_Spr`in/flers _Generator Woof
Total Sq. Ft of Construction: n r J� ! 3 v Sq. Ft. of First Floor:
Cost of Construction:$ , qOz) Utilities: _Sewer _Septic Building Height:-.
Names ,
ame: VMV LA—
Address. ApQc��
ompan •
I
Stater
Zip Code: Fax:
. 'il
Phone Nok(25-
Address:
Z
City: VKa S1 • LJ Ct-f— State.
Zip Code: Sic 55- Fax:
PhoneNoo..r-0D—a46(-0�B(,r
E-Mail: �IT2�Q�tIQ ��]IKl
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: L, Qfl�► �:)9 Coy rnev- •.
State or ouC unLicense: 1 1��1 RA
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
Name:
City:
Zip:.
FEE SIMPLE TITLE;HOLDERs; V Not Applicable _
Name:
Address:
Zip: Phone:
MORTGAGE COMPANY: _L/Not Applicable
Name:
Address:
City: State:.
Zip: one:"
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
certify that no work or installation has commericed•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 youYdeed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that 1 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
commencine work or recordine vour Notice of Commencement.
Signature of Owner/ Agent/ Lessee
Signature of Contractor/License
STATE OF FLORIDA
STATE OF FLORI��
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument w s acknowledged before me
this day of . 20_ by
this ay of 201') by
(Name of person acknowledging)
( me of p rson acknowledgiing )
(Signature of Notary Public -State of Florida)
(Signature of Notary Pu ' -State of Florida)
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification Produced
Type of Identification Produced FFT
g�w.rv,}t
Isslon#FF949733
Commission No. (Seal)
Commission No. __•;
`v^-�xpiies January 12 2020
_
I ' h0.^ eaa.ernNrrnra u�n.e.emaesm+
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS__ ..
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
d
DATE
COMPLETED
Rev. 7/2014
DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY; otApplicable
Name: CA -e_ Name: _
Address: b i Y Address:
City: JGt State: f City: State:
Zip: _gc ql _` Phone: r1`� Zip: one:
FEE SIMPLE TITLE HOLDER: V Not Applicable
BONDING COMPANY: otApplicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip:
OWNER/ CONTRACTOR AFFIDVIT: Application ishereby made toobtain a todoj�eworkand lnsa rn Indicated.
p
I certify that no work or installation has commenced prior to the issuance of a It
St, Lucie Count makes no representation that Is granting a Permit will autroriz e r i oide to bulidfll�su ct ucture
structure.PleasleconlsultwithpyourHomeOwnersAssociationandreviewylour for nantst itnswhichrla car Ibitsuch
In consideration of the granting of this requested permit, I do hereby agree that l wi , In a for j
In accordance with the approved plans, the Florida Building Codes and St. Lucie Cou ndments. L ,
The following building permit applications are exempt from undergoing a full concurren y 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 twicefor
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
commencin work or recordin our Notice of Commencement.
Signature of Owner WgenVPersftse1e Slgnature of Contractor/License MoIder
STATE OF FLORI A p STATE OF FLORI
COUNTY OF COUNTY OF
^rne,
The forwing Instr t was acknowledged before me The f r ping lnstrumentw s acknowledged before me
this,Vday of z017 6y
thlQSLday of 20L by _
�l`
ame of person acknowledgin ( me o p rson acknowledging )
(Signature of Notary Public- state of Florida) of Notary Pu -State of Florida }
Personally
Personally Known �OR Produced Identification Personally Known OR Produced Identification
y
of identification Produced
Type of Identification Produce pe
�
gt^ vq,S _ � g� Issioa # FF 949733
yRmission # FF 949733 mmisslon No. ; { �a tf8s January 12, 2020
Commission No. _ • v p 9Janua 1 2020 �� P
P ry 2,
k Qd„P� s�,awrnwu=yrmwwxWe.OMMia
SUPERVISORNING
REVIEW PLANS VREVIEWON SE EVIEWLE MANGROVE
REVIEWS REVIEW
CFRONTOUNTER REVIEW REVIEW
DATE IQ
RECEIVED
DATE
COMPLETED
Rev. 7/2014