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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: l I l5 Permit Number: =x RECEIVED AUG 0 G' 10J5' ' :.. � Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential- PERMIT esidentialPERMIT APPLICATION FOR: �cmo, I- -bn '�)cf 1 PROPOSED INPR01/EMENT LOCATION: Address: QMcm Legal DescriptionrAQDCPCICQ(V%ftlb%V-D IVKLIMOPSIK LY( f�1 111'1 1.11Ch�� lDFSTAD 6 SIrj 10C.A vc k=!L d 40C STS N4'In or 335- 2 90C2:3d9 (Or 3 91-41`11 -319�,:D34-25-19) Property Tax ID#: Sff)87-- E)DI-Co P-Q 10- 4 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DE AILED DExSCRIPTION (5F, WO4100 RK. r _ CONSTRUCTION INFORMATION: itiona wor to a pe orme under this permit-check all that appy: _Mechanical _Gas Tank —Gas Piping _Shutters �Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: FVQ Sq. Ft.of First Floor: Cost of Construction:$ 9 .( b Utilities: —Sewer _Septic Building Height: 01ND LE=WS�SE : C®NTRACT®R; Name Name: Addressi �qS�.S,end I"n IoC1r (. Company. City:slf'( x1 State: Address IS.E. Zip Code: WSD Fax: City: State: Phone No. Lu.1~jl—oced Zip Code: Fax: 13 E-Mail:_t,,XIA Phone No Fill in fee simple Title Holder on next page (if different E-Mail Lo 1f) 1' Q { ,('C from the Owner listed above) State or County License 19 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S[J'�PPLEMENTAL C©NSTR=tJCTI.ON LIiEN LAW 1NIFORMATtO DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable m Nae: 1 " e Name: Addres 1 r Address: City: �1 lc)(Ary State: City: State: Zip: Phone 1 Zip: Phone: FEE SIMPLE TITLE HOLD Not Applicable BONDING COMPANY: Not Applicable Name: I I(eq_n Name: Addss. Address: City: City: Zip: Phone: - AN k Zip: Phone: OWNER/CONTRACTOR AFFIDVIT: Application is hereby_Jnade 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 OWhers'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 ermit-, I-do hereby agree that I will in all respects,perform the work in accordance withjt a approved plans,the Florida Building Codes and St. Lucie County Amendments. �,., . • , i r . . . I J _ 1-1-, . . I The following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen,ro'oirns 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 'obsite before the first inspection. If you intend to obtain financing, consult with lender or ney before commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Agent Signatur of C ractor/License Holder STATE OF FLORIDA STATE OF FLORIDA . COUNTY OF COUNTY OF- The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20_ by this S�j day of 201�by (Name of person acknowledging) (Name of son acknowledging) r (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida ) Personally Known OR Produced Identification Personally Known Z _OR Produced Identification Type of Identification Type of Identification Produced Produced _ IRENEG.PINTO Y t Q;'; )7+dMISS10N li FF 20W April 4,2019 Commission No. ' ' (/Seal Commission No���� =' s', �' II���,��}} ' (Seal) � Rinry�8`PISAI�toryPubl'roUndeiwriters� mom :'REVIEWS, �, -FRONT ZONING SUPERVISOR PLANS VEGETATION.: SEA TURTLE MANGROVE COU.NTER, REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE i RECEIVED DATE COMPLETED ev. DESIGNE ENGINEER;. _;Not A :plicable Name;,. . P MORTGAGE COMPANY: Not'Applicable _. . , Na 4ddres' me: r: Address: City - State C . ity ._.._ — -. - - , . n _ Zip • . Phone' :: .►. ,. .. zip.: Phone: - - tater FEE$IMP E TITLE HOLD Not Applicable BONDING:COMPANY: Not Applicable Name: T. :4 Name: - : : . - -- _ Address--Addr ss - CiCity. Phone _ Zip' _ Zi Phone! ._,. p, OWNER/CONTRALTOa:AFFIDVIT.,Applreation is hecefiy�t -6 a to' itbi' n a permit tb do,tfie.work and,installat t as indicated.; !:certify that no`work or instailatioo has commenced priortoahe issuance of a perrtiit: St.Lucie_County *logo representation that isgraLitmg a;permit y►irI authorrze,the:perm(tholder to bwld the subject structure which is rn conti with any applicable Horne Own"ars Assoc atron rule,byiaws or and covenants that may restnct,or prohtbltsuch. structure Please consult`w th your.Nome Owners Association Arid reiiew your deed for any,res tnctionswhich.may apply. Inconsideration of.the granting ofhis requested permit,I d hereby agieerhat I`wlll,in:all'respects;perform the work Ira a ccordanci=>rlrith 0e approved plan$,the Florida.Budding Codes and St...Lucie'County.Amendrgpdts I, . . , ar , The following budding permit appiications'a, re exemptfrorn�undergoing a full concurrency review room addttons, accessoryst(Gctures swimming pools,fences;�nralls signs;'screeh roolns.and accessory usesio.another non-resrdentia(use. WARNING TO OWNER:Yourfallure'to Record a Notice of_Commencement may�result ip your payin Awice for- improvements to-your.p.roperty ,A Notice of:Commenceroent must bo recorded and posh d:on the-obsite before the first inspection If:you intend to:obtain:fnancin consult with lender:o� ne a o___ - g,. Y commenci m-workvrrecordin our Not of Commencement. d `' -. Signator of C actor/Ucense Holder fi. ature of Owner/Lessee/Agent TATE OF FLORIDA STATE OF FLORIDA - C..:i1NF ' " = �f- coUNTY 0!F .f: The:fojgomg Instru en t vias acknowledged befoeerme The for oing'instru entwas ack_nowle.d. before mei this.�P `iiay of_ _ Cs'_ ^ 20y this: day of 20by (Name of,p"_son acknowledging) (Na"iiia Of son acknowledging:) 5. (Signature of Notaiy Public-State of Florida) •(Signatu.e.of NotaryPukilic-`state o Florida.j Per.sonally Known A OR Produced Identification._. _ - _ Personally Known._OR;Producedadenog0tion. . - Type of Identification - Type of,tdentificatiori �,, _ Produced 131PW O Produced IRENE ' . I ,. ;� MY C041MI5SIbN9FF�57 � G � kol C,ornmission No - �JG ;. RES.April 4 2019 Commission-NoS ' t9 E3i�Nol Pubic Undw rvrtflra -. . REVIEWSr _ rFROiVT ZONING' SUPERV.ISOK. PLANS VEGETATION- SEA TURTLE' , .MANGROVE = COUNTER REVIEW: REVIEW REVIEW REVIEW. REVIEW REVIEW -DATE l RECEIV;-D DATE _OM PLET 'ED- ev. _ 4`Q� I'ini�ngoYsra ►,rn� ASBESTOS NOTICE, • 13u!Idteii�Gi�Melt�Qugi��a�i�Ion _ 2300�Onbiaveity� t`�rt P �co1F�-3�98� i�hoaet(77;Z 2172 �axt77��62�6443' Asbestos=Notice,to Contractor AugustQ6; 2015 WINN BROTHERS CUSTOM,HOMESINC' ROGER;p WINK 2428 NE CENTER ST JENS EN BEACH', FL 34957 RE Building P.ermit,Number 1.508-OQ?7 lt.is our res ot�sibili t y p ty:o comply with tk►e provisions of Section 469.003, Florida Statutes•and to notify the Departtnenf of EnyirorOmental Protection of,any i�tWion5 to remove,asbestos uvhen applicable in.accocdancerwith skate and;federal aw k �r' ,r gnature t' Date 8(61201510.22:39 AM