HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: %• % /� SCANNED Permit Number: / V O � /SJ
BY
S � - 11111111110
t. Lucie County
• -ME LIP
_ .
Building Permit Application JUL 9 2018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce F134982 9 P
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ✓ esiSIntlWizie County, FL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
I PROPOSED IMPROVEMENT LOCATION: I
Address:
" 1 ' • • I.�: 'e � _ �� /' era _/ '� /� 1 / ._.11 RO U r.1 •
Site Plan Name:
Block No.
Project Name: -The_ f'4.4-v iuvj oy) fihw-(Dceo.,n:g Coidloo ASC6r_ lO a..
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK: III
RC--ov- and, reps cL&e. ovaf-o I,67$ rr'`or- cuei•rou�i P,II,4/5 and aJapiy
a-C.0c%+5 0t-- Q,ucvi)InUV-GoI ovie- Cov` V30vie,-t- MLi{otnaf'j'c. Po(ytJV„ jjh tvje.
lilaSFo:� e.oai-jnS -t-o ; h'-_ Loy j S1ovoc& 3 Uv(—at-e.
CONSTRUCTION INFORMATION: III
❑HVAC Lj Gas Tank ❑Gas Piping UShutters ❑Windows/Doors
r
❑Electric ❑Plumbing [:]Sprinklers❑Generator _Roof �lYI Roof pitch
Total Sq. Ft of Construction: I U 75 (,&-0 S Ft. of First Floor: I)
1
Cost of Construction: $ (OS, nAct , O Utilities: Sewer.❑Septic Building Height: 'j a"L4
OWNER/LESSEE:
CONTRACTOR:
Name_7(t ATmi- rri O[,I -MF- 0U-M COACb
Name: TPrrn
_C__a4GSIC.oLI)
Address: ?A= f 1, 611 A ���
C•
Company: L.a�'ii�
$ Sler+ V-1—_+a) Co
City: y( 'Pi Laf:j"e State: (.
Zip Code: _20 °Itl a Fax: 11" A
Phone No. (9 0 7755-- QSf79
Address: ��$n id.
C_e) ncm S ✓tcl.
City: (?n-.n Ion v, o r3
Zip Code:
Phone No. FELL 7-21-RLfU6
ne GIn State: -EL -
Fax:
E-Mail: tj14A
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: IA n i 1 by -'I (+c
) (F, I r, f 'i-e.. Co�j
State or County License:
t✓Ce O si5 of &7
It value of construction Is ,iZ5oo or more, a RECORDED Notice of Commencement is required.
e
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
N _ ot Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
ZNotApplicable
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.
1 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 vour Notice of Commencement,
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signa re of Contracto Ice se Hol
STATE OF FLORIDA
STAT LORIDn
COUNTY OF 31 �6k[V7
COUNTY OF 3 R-O:>
The forgoing instrument was acknowledged before me
this day of L a 20� by
The forg ing instrume t was acknowledged before me
this SIN% �1_" . 20 I� by
VITO PomeE &E (?r2J_'-5iDai-4T)
SFirciEs T__711iG5lLoc-�
Name of person making statement ✓
Name of person raking statement
Personally Known OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced a• L ,
Li& 14
Produced
01N1�✓ft�1 0 Uc��
(Signature of Notary State of Florida I
(Signatufe of Notary Public- State of Florida
,,Public-
Commission No. 5 a �1}NTfIIA CIiAND
lF % D}(ghTH]A GRANDEE
mmission No. G
MY COMMISSION # GG42
MlssloN#GG4242
26aM1,r EXPIRES: October 26, 202
as EXPIRES: October 26, 2
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
'
COMPLETED
Rev. 8/2/17