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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: T� 9 Permit Number: g SCANNED BY - St. Lucie County [RE�CEIVED Building Permit ApplicatioN 18 2019Planning and Development Services County, Permitting Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial '✓ Residential PERMITTYPE: ft GnTi k) PROPOSED INPROVEMENT LOCATION: Address:1100 )tintlsr im 21+k Sheet, R Pierce P-c. 34251 Property Tax ID rr: Lot No. Project Name: DETAILED DESCRIPTION OF WORK: INSr"uAmorJ Of-_ 5 Zone (triQa4;o» 5y5lem CONSTRUCTION INFORMATION: Utilities: _Sewer _Septic Sq. Ft. of First Floor: Cost of Construction: $ C� Total Sq. Ft of Construction: FLOODPLAIN DEVELOPMENT PERMIT for structures exempt from Building Code that are in the floodplain: Nonresidential Farm Building: _ Temp. Bldg./Shed used exclusively for construction Mobile/Modular for temp. construction office: Bldg. involved in distrib. of electricity: Other: Flood BFE:_ Floodway? Y/N If Y, No Rise Certificate with supporting data attached? Y/N All other applicable state and federal permits shall be obtained prior to commencement of construction. OWNER/LESSEE: CONTRACTOR: Name Name: 4_A1-'0nb_P0'o LCm.)n*UkniscavE Address: Company%�i Q\5%\1W CWke0e. Why. City: State: eL Zip Code: � Fax: Phone No. Address: �aaO Lk 'a[1 SI. City: `A(a Qj0ch State:_ Zip Code: 32961 Fax: Phone No —l"1 oZ ''J(oq - 6 Q fOIVX' CQ', Fill in fee simple Title Holder on next page (i different from the Owner listed above) E-Mail QIShx© C.Or"'1 on, State or County License off.9 z2 n If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. r -t If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: EER: Not MORTGAGE COMPANY: Address: Address: City: State: City: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Address: City: Zip: Phone: Address: 23 Not Applicable _Not Applicable 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice of Commencement. . Sign ture of wner/ L s e Contractor as Agent for Ow Sign re of Contractor/License Holder STAT F FLOW — STATE OF FLORID COUN OF COUNTY OF INSifl A(}�-SL The f oing i tr ment was acknowledg before me The for oing instru ent was acknowledge before me thisMdayo by this dayof1111MALI" 120a by �c .m Name of person maki state nt. / Name of per n making statement. Personally Known deeed-1 ' ' ation `' Personally Known OR Produced Identification Type of Id e!r Type of IdenWickign of aaa Fes Commission No. —1 AMBER BRYDE Notary Public, Stab of o da omm ss Doti My gem. egires tart 2 , ea FRONT COUNTER I EV REVIEW I S REVIIEW R I REV EW VREV EWON S REV EWLE M EVIEWVE DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _ 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 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.l 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 rev'iew:.room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to' arioth'er 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. Sign'qt re :of wner/ Lessee/Contractor as Agent for Owner •: Signat re of Contractor/License Holder STATE OF FLORID STATE OF FLORIDQQ COUNTY OF �11(�ILLfI CZ1\I eY COUNTY OF \1(�c1\ a1M R\yW The forgoing instrulpent was acknowledged before me this 22dayof 20_4 by The for oing instru ent was acknowledged before me this fro _ JG(VQann "2qa by cu.Ji�n Name of person king statement. Name of person ma ing statement. / / Personally Known OR Produced Identification V Personally Known OR Produced Identification Type of Identification f Identification Produced �L LProd DELEON ed �aDNtarylic, State o1 LucsA GG 4 aCaionS 221My rumexpires Nov. .2020 My Comm. expires (Signature of Notary Public-Sta tort (Signature of Notary Public -State of on a Commission No. Na 141-2b-Lu (Seal) Commission No. LCA 14 1202D (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED nev. 9/26/its 9 r ,n, � FlOda 14,2020 79einiT C,,) 67-LUCIC,40 C P,/,' --Plex6e AjqVe q611q1111e 04HY-iee4 k044-- -r ewmil ,one. SI-717 �(11V�