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HomeMy WebLinkAboutSUBMITTED PAPERSAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Datee Planning and DevelopmentServices Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: SCANNED Permit Number: / � . ` y/y BY 9t. Lucie County Building Permit Application Commercial Residential -ter Address: 900 F7- P/-ere j Legal Description:. $- ?6- Vy f_ /5-v FT a (- k/ 3vv .4f ed' , 35-5,7 rt-,- r' g V25- k-1 eecC Y-L Wti 3a AC i nib / U F s /� Y�-1- 54-csc Property Tax ID#: 3110 -e/// - hUo4-C�UO-� Lot No. Site Plan Name: Project Name: Block No. Setbacks Front / D Back: /,0 Right Side: 10 Left Side: 10 rax- aitionai worK to .De perrormea unaer tnis permit- cnecK ail tnat apply: _Mechanical '1�tas Tank Gas Piping _ Shutters _Windows/Doors _ Electric Plumbing _Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: Utilities: Sewer, ._Septic .._ Building. Height: _ _ �y ..q.�«. F'k .L a�,�FS ,z,���nf ,- ''a_'fa•%..{.L;3:h�al..;r$�iit—tV"t3 rr�.....�.aTl�.!�.1y:ffti n'• i +1 ?...fik' •a:r'L.c'`.�:P�i'F'a.!li. W �k fi& •J« COI`ts qR<;{.} ., 2"'tl''A.r.S#-.S�j45XaK4?iliu: a..i#fi 2:_"?x.�LStV�- ,i.: � s4vy-• ,'1 Name Rdc1al66 1/0 to ,-I Name: rlh /J 975 r► Address: qoq Company: _19M.Pni G'a r City: State: Address: 3Sal Q1-Ao.v,,A. 4� Zip Code: 31/ 991- Fax: City: tT p-ere.r Stater Phone No. 77 z-- 9,1(J- 36�V Zip Code: 3 y9 J06? Fax: 7 2 2- - W f! yy #0 E-Mail: Phone No­?-?9 -6.53 -0*250 Fill in fee simple Title Holder on next page (if different E-Mail: l / yr from the Owner listed above) State or County License: 5�7 -if value of construction is 2500 or more, a RECORDED Notice of Commencement is required. P��#' 1ki.{p$` e,�ts=-=f' .L���.�"�"� �{: � • `.e+�',d�- 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: Ci#y: 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 toahe,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 Nome Owners Association rules, bylaws or and covenants that may restrict or prohibit such Wucture.,Please consult with your Home Owners Assoclation'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 SC 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 im ov�ments to your property. A Notice of Commencement must be "recorded and posted on the jobsite fore th`e.fir ' `ection. If you intend to obtain finan ' , c : 'suit lender or an attorney before c meno�i k r r din'" our Notice of Commen- "m nt ev. OP :4'y�{�c�'�y„��U f�� �,E�r,r�'-._"?s Mgt- d7/2014 17� ( Sig atur of Agent/ Lessee a ure o ntractor/License Holder STATE O RID STATE FLORIDA Lucc.� COUNTY OF T<vcN COUNTY OF ST The for oing instrument was acknowledged before me �' � �r by The for oing instrumentwas acknowledged before me La this day of c . 20� ,(q � ✓�n1 this , day. of C7c 28f� by r'% G J (Name of person acknoweedgin ). (Name of person:acknowledging MICHAEL MILEY (Signature,of Notary Public- Stat ` f Florida) (Signature of Notary Publ i my 1i3.2018 .. M�� Personally Known OR Prod i icatiMY .: E�ally nown Type of Identification Produced lurdmis" 13 ��� tifisation Produced Commission No. �� �%7�LYJ . • ExPIREs �� ��issio No. ��z , f I ST. LUCIE COUNTY BUILDING DIVISION REVIEWED FOR COMPLIANOE REVIEWED BY DATE PLANS ANIT MUST BE KEPT ON J00 OR NO INSPECTION WILL BE MAPS FILE COPY vA O -J'dCi /J 'Pr lor;P�171 "Ite 904 Osceola - Google Maps Page I of 1 Imagery @2014 Google, Map data @2014 Google 100ft https://www.google.com/map"s-/'-piace/904+Osceola,+Fort+Pierce,+FL+'-i4y82/@27.35778... 10/29/2014. '-' /-` i �./ -� � ^" ;.ram PLANNING AND DEVELOPMENT SERVICES DEPARTMENT `` M Building and Code Regulations Division 2300 VIRGINIA AVE. FORT PIERCE, FL 34982 (772) 462-1553 Fax (772) 462-1578 PERMIT RENEWAL REQUEST PERMIT NUMBER: ;3LCi 1 yI0 —16%/ ADDRESS:_ I, C'�t s r-t am requesting that the above permit be renewed. I understand that I must schedule and pass all required inspections for the permit to be finaled. Further, I understand that this is a ONE TIME RENEWAL and the permit shall expire should I not receive a passing inspection during any six month period during the renewal period. rant Name STATE OF FLORIDA COUNTY OF :SIT Lucy -I ACKNOWLEDGED BEFORE ME THIS DAY OF. AQrt / 20_16_ BY L/grM WHO IS PERSONALLY KNOWN TO ME jk , OR HAS PROVIDED FOR OFFICE USE ONLY: Number of Open Inspections: Total Inspections: (Divide open by total to get % of open inspections) Percentage: Original permit fee: x % open = $ Renewal fee AS IDENTIFICATION. ;t';. . MICHAEL MILEY •': MY COMMISSION # EE217600 s • , EXPIRES Juty 18, 2018 (d07) 39Q-01S3 Ro"M Example: [15 divided by 23=.65(%o)] $175(permit fee) x .65=$113.75 (renewal fee) Revised 6/24/2014 PLANNING AND DEVELOPMENT SERVICES DEPARTMENT Building and Code Regulations Division 2300 VIRGINU AVE. FORT PIERCE, FL 34982 (772)462-1553 Fax (772) 462-1578 PERMIT RENEWAL REQUEST PERMIT NUMBER %r ICJ — O y3 / ADDRESS: ytq�/, I, , `!+ v 7/- am requesting that the above permit be renewed. I understand at I must schedule and pass all required inspections for the permit to be finaled. Further, I understand that this is a ONE TIME RENEWAL and the permit shall expire should I not receive a passing inspection during any six mo th period during the renewal period. n -�7`LL /9 J�sti':ficn� iJ � �.,., e i s yc T 4 D.v // / N �/%� /9.Lc..a %!�, v s 7�,• SIGNATURE Print Name DATE STATE OF FLORIDA COUNTY OF ST LutiJ ACKNOWLEDGED BEFORE ME THIS 2_ DAY OF � � 20-/-� BY 4&4 ),C n s-i1 WHO IS PERSONALLY KNOWN TOME l✓ , OR HAS PROVIDED AS IDENTIFICATION. STA F FLO A, Co of EY •���•, MLJUIY -`• ••'s MY CE217600 SIG . ATURE OF NOT Y s ,. E018 p0'>) 3Y60133om FOR OFFICE USE ONLY: Number of Open Inspections: l Total Inspections: (Divide open by total to get % of open inspections) Percentage: Original permit fee: x % open = $ Renewal fee Example: [15 divided by 23=.65(0/o)] $175(permit fee) x .65=$113.75 (renewal fee) Revised 6C412014 SEP 2 2 2015 OFFICE USE ONLY: DATE FILED: REVISION FEE: • B C 1. PERMIT # T 1 1)' ©T "311 RECEIPT # ) t1 :2 1 _"7�• PLANNING & DEVELOPMENT BUILDING & CODE REGUNWO 2300 VIRGINIA FORT PIERCE, F 9 (772) :462-1553 FAX VICES BY APPLICATION FOR BUIL PROJECT IN g St. Lucie County LOCATION/SITE TV ADDRESS: �f" t� CSC P�/� ��< /- � / /Pry 2. DETAILED DESCRIPTION OF PROJECT REVISIONS: /17 Uc,�1r/ �rJ�i , 41�� �:- L/a.� ziy��s • 7� ZZ FILE COPY 3. CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: ST. LUCIE COUNTY CERT. #: BUSINESS NAME: QUALIFIERS NAME: Lti ADDRESS: 3 6 f CITY: /-7- /Q/ STATE: ZII': .3,plypq- PHONE (DAYTIME):J7z- 63 3 69V61 FAX: '77Z 01 kw 4. OWNER/BUILDER INFORMATION: NAME: ADDRESS: CITY: PHONE: 5. ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: PHONE (DAYTIME): Revised 07/22/2014 STATE: ZIP: FAX: STATE: FAX: ZIP: LtCOPY )6rry7: /yj 0 . oval ST LUCIE COUNTY BUILDING.DIVISION .FoRcomp REVIEWED BY�DATE- PLANS- ND-P RMIT - MUST BE KEPT ON JOB OR BE MADE MO INSPECTION WILL 799 Jam- o