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Home My WebLink AboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: SCANNED Permit Number: nfiO BY f St. Lucie County �Fc a s Building Permit Application v �o 9 q -_"Planning ondDevelopmenfServices- -- Fsya?.� Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 ✓ Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: P Ca S -D I 0= OGA rMP I Address: (OIgZ� KI LkrS :41!G'L,W7-! ( Property Tax ID #: L i o (0 0nLot No. Site Plan Name: Block No. Project Name: ' DET O D 0 F W(1RAll nainT%l )21% B C �/ rn4 ny.r✓ L✓a�ll /��dM �+�n 2 ,A � I> It (gyp (JOY iCr da �1 t—��1(iC *I hDul rri/IWI. /.tldYnya �j12'i/�ioam / i e ecr-uPW� e—" Ie�Cpr rs�Pd of d f� Additiona ork o be performed under this permit -check all that apply: _Mechanical ) _disTari --', _GasPiping _Shutters —Windows/Doors Electric Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: 38755C X 47(w = Sq. Ft. of First Floor: Cost of Construction: $ Utilities: ✓ Sewer _Septic Building Height: e ME L SE e� O Cyr, N ddress:J 74 r C GT i Company: li{Zh � r61CttQ lfivr Iame _ko 4< wy Fl- Address: �22i Cj1J I QI ('I `�ip City: y Stater.�ione'NoFnrrw sState: Code Fax: _.%..: ZipCode: Mail- �Fax: Phone No 141-2--Ilp—fi t-7ko Fill in fee simple Title Holder on next page ( if different E-Mail CPI ks�Ct GL ti �f UlL7A (Yl �i oIMG 1-C�r ) State or County License �il C 1r2-F, O6R r m the Owner listed above) 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. 4'k4 r 1� 4- 5 PP � 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 OF COMMENCEMENT." 1 - CO � RU Ito N ( 0 A O 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: Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA,,,,, COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The for ing instrkment waj acknowledged before me this _day of , 20 by this ay of IIPGCA.t hhOtr. . 2014 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Type of Identification Produced Produce ✓ /1 — ( v w (Signature of Notary Public- State of Florida) (Signature of tary Public- State of Florida ) K�nC� Commission No. (Seal) x - �MM19510NMFF Commission No. F(=a CA t & p(PIRES:MeY23, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Not Applicable I MORTGAGE COMPANY: _ Not Applicable 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 the issuance of a permit. St. Lucie Counttyy makes no representation that is granting a permitwill authorize the permit holder to build the subject structure which is in conflictwith 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 "WARNIK TO OWNER. YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWI FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND PO T ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT no .0 AT noucv nccnoo vornonnuc vnim NnT1GF nF COMMENCEMENT" gnat wner/ Lessee/Contractor s Agent for Owner Signature of Contractor/License Holder ;ESTATE OF FLORI 42 STATE OF FLORIDA i COUNTY OF G'e COUNTY The forgping instr�was acknowledged before me Kay The fo�rP9ing mstrkment wap acknowledged before me by this of_(/ /I .207Q by thisTMayof VfALAdhAft .20_4 C_ X-0 LG e'A I ia'rl bc�l 7"=Jm Name of person making state t. Name of person making statement. Personally Known // OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Type of Identification - Produced Nomy Pubrc State d Flotkla Produce • Sharon LGrllfitli • m_IWan GO ID7089 .� 5127I2D41 (Signature of Notary Public -State of Florida ). (Signature of tary Public -State of Florida) W,ncNN+ rmssionNo.� (Seal) ,wY'p�,� Commission No. F� 'Z( =o,••F7na ,�MMISS10N#FF • � pIPIRES:MeY� �REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Nev. t/ i/ 19