HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
f Permit Number: WU atas
Date: t�fl-
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ion OWQI F, =iII1111111=0 RECEIVED
Building Permit Application AUG -if 2018
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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AddresFJqPJ7Jo�for4 '4- ?61V-C 'iLA-
Legai escription:
SCANNED
PropertyTaxlD#: W4 11 12-3 - 0 00`4 - o0o - 6 st I I fide Cg, l;#;, Lot No.
Site Plan Name: Ili Block No.
Project Name; lzc� �f.
Setbacks Front 145' Back: U Right Side: so. 41-eft Side: _AVA
Ism A OR -i
:[9 W '14 IALL—
DW ithl OACa 6_?AC1r1' LWI; �,IXVJ ��..Ues -r>-.-V_Aa79b.
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Additionalwor o e e ormed underthis permit— cneCK all apply:
kt
11HVAi oMrG'asTank Das Piping In Shutters Windows/Doors
ElElectric 0 Plumbing OSprinklers ElGenerator Roof Roof pitch
Total Sq. Ft of Construction: 5 Ft of First Floor:
Cost of Construction: 4 10,00p Utilities Sewer E]Septic Building Height: 1211
Name Aik�l, brdv�-Vt o�. �wX- Name:
Address:AaAl Ix. YL&OW 'L. kiAlt lljt.O.Company: 09- How, 0 F
City: '10,U,A State: Address:
Zip Code:. "33 Fax: City: State:_EL
Phone No. 9 I?S - ZS 4 - 4q 2,4' Zip Code: Fax:
__3
E-Mail: NT7krA. -S co-K 4 tAAfJZC� - Phone No. 9?Z- 6U-15-b"
Fill in fee simple Title Holder on next page (if different E-Mail: Ot hki? 6 S6,; q fALk 1CL ia
frorn'the Owner listed above) State or County License: t,
t
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
C
Name:
Address:
City: - . State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Name:
Address:
City:
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anscovenants 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 concurrencV review: room additions,
accessory structures, swimming pools, fenceswalls, 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 th e first inspectio(n. If you intend to obtain financing, consult with lender or an ney before
commencing work ordcordb�g Your Notice of Commencement. f !o�r_r
ture—o
SignaZ er/ e r as Agent for Owner
Signature 011� Qon or/ i ens ol
1W
Vsee
STATE FLO
_:. �4 7,
ST, ATE OF FIL
?7-
COU OF. rt
COUNTY OF
The forgoing instrument was acknowledge beforeme
The forgoing instrument was acknowledgid before me
this\0 dayoi�yaiv'_ by
this \6 day ofZ51A V%, .2611 by
1) YNA. c c— (ii,
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identli
Type of Identili *on
Produced
Produced T X.,
(Signature of Notary4bublic-SSLtate
(Signature of N
u Ic a e o orlda
DEANNAMARIEGiVENS
Commission No. %*4%al CoMm(fts"OGG022021
Commission No.
NS
11-z,�%A:V EXPIRES: DMITIbef Ill, zuzu
Public Unda" tam
10 22023
EXPIRES: December 16, 2021
BondedThru NeMY
- - - - - - - - - - - - ad
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. alz/i/
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 120&
REItEVED
Building Permit Application AUG
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Farmlttin9
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial 90'�' Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRO PCSED-I MPROVEM ENT LOCATION:
Addres4OP171i),yori ?C^- IiL'A'
Legai escript ion:
Property Tax ID tt: 8,1411-12-3 1 Oooq - goo- Lot No.
Site Plan Name: Ai JA Block No.
Project Name: ?zac'e. I 7m-
- woa'c� �t, iA23ZA7 Ill( Act'
Setbacks Front LiS' Back: ZO Right Side: Iso.41-eft Side:
- , 1. 1. 1 1 - I ___1 I �. �11 - I I � '4
.DETAILED. DESCRIPTION. OF WORK:
S+ IALL—
it?,, ota 6?Ac, fA.P-, LAI
,CQNSTRU,C, I0,NJNF9RMATI6N:"
Additionalwor o e e ormed under this permit - check all apply:
11HW "fl'as-rank E]Gas Pir - Shutters Windows/Doors
11 Electric EJ Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: "�q je 0 S Ft of First Floor: 1,1915 (h
Cost of Construction: $ 4 Utilitiescn. Sewer L-1 Septic ' Building Height: 12'
�;OWNE R/LESSEE:1
T(
RAC OR
J1_
Name Mlk5iiz A. swv_-
Name: -�,Frty
Address: IM 7--X. titAiLlig I. leontr T#Jt'Company:
blkruolsj[AL CS+
Vvd ai?mel zx
City: '14,%',A State: M
Zip Code: '33 Fax:
Phone No. 9117S - ZS 4 - qq%,-,
Address: 32L) 07vass LAY4bi,nf6-
T)lz,.
City: Lom(= aA*�
Zip code: - _111 Fax:
'4 2
Phone No. 9(0 1 f 2-o -- 'S Sq 2�
State:_0_
E-Mail: NvAi,-k. /� cv-T'r 0, r'&A!r1zC�_ il^'
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: NI_T�p 1 t4c- 0, eNWIALi9k. 9-.:T
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. I- 41MIA11%
el
I a
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable.
Name:
Address:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Name:
Address:
City:
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 Coun makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
Mict with any applicable Home Owners Association rules, bylaws or an covenants that may restrict or prohibit such
which is in co 1 1 9
structure. Please consult with your Home Owners Association and review your deed for any restrictions whic ' h 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 vaurftotice of Commencement.
as Agenyfor Owner
STATE 0 ' "ORIDb STATE OF F1
COUNTY OF COUNTY OF
The fgrigging Instrument was acknowledged before me
thIsMdayof 01fA9JZ2!i- 2018 by
Name of person making statement
Personally Known OR Produced Identification - V-1
Type of Identification
Produced -Ft- hyllh-pst'le.
A
(Signaftu, e of Notary Public- State of Florida )
Commission Nofi'qOlqZ�q (Seal)
REVIEWS
Rev. 8/2/17
Theforgoing instrumentwas acknowledged _4efore me
thisaq day of at pc�l 20ff by
Name of person making statement
Personally Known OR Produced Identificationv
Type of Identification
P roduced rL biat"'z-, 0
(Signature of Notary Public- State of Florida )
Commission No. /912?& leg i (Seal)
PLANS I VEGETATION
�EVIEW REVIEW
' Pr
CIA
9