HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
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 APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: Q �r T �e, r` c 471, 3
Legal Description: -P0 t vk q f o L_o Tl� e_07- Sa r7
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name: qDp\ t i I
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF.WORK:
�2-
CONSTRUCTION INFORMATION:
Additional work to be nertormedunder t is permit-c ec a appy:
HVAC Gas Tank
Das Piping _Shutters Windows/Doors
OElectric ElPlumbing Sprinklers U Generator QRoof
Total Sq. Ft of Construction: -�a 0 d S of First Floor:
L]SewerF]Septic
Cost of Construction:$ " 3 3 6 Utilities: Building Height:
OWNER/LESSEE: CONTRACTOR:
Name -21\ I, I-Lp Loo-a"Q'n t'o Name: cr6I,v, (9 C=A,v,,vGV--
Address: cS-9-'W4 ` 1 rcz,?J el (zis Company. X06,v_ "�-
City: State:7� Address: 0..5 C,Tr�.s car iL 13(✓
Zip Code: 3Y 48>— Fax: City: �;R State:�,/
Phone No.V31"_74 1./79,5S Zip Code: Fax: 7 z a-a
E-Mail: Phone No. 7 72 -0-2-o-L—
Fillin fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: 2000 6C--?,gq
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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:
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 our Notice of Commencement.
ca:�. pc,. s
_Sig ature o wner/Lessee/Agent i ature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Sk . COUNTY OF S .k.e bx
The orgoIng instr ent was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 Eby this p day of t)� .201k`S by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-Stat6 of Florida) ignature of Notary Public-kate of Florida)
Personally Know OR Produced Identification Personally Known 0 P
Type of Identification Produced Type of Identifrca n ��[a W ed LASHAHNA INGRA
::os` e
Notary Pub is- c 20 2018
Commission No. HNA INGRAM Commission No. ' ` *;•5 My Comm.Ezps q@177249
"„ s,� o-p,; Commissidn 1
S 0 P��11% Notary Public-St2te of Flotlda
rpires Dec 20,2018 ''�',°;;Y°`� Bonded through National Notary Assn.
N, oma; Commission wly
#FF 17724 - - "
Revised 07/15/201 ''4', OFF�:�
t Bonded through National IN
Assn-
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
JOSEPH E.SMITH,CLERK OF THE CIRCUIT COURT
COUTY
NOTICE OF COMMENC FISAINT
#T 10 61 6 08i ON 0 5 at 12:56 PM
OR BOOK 33779 PAGE 2703-2703 Doc Type:NC
RECORDING: $10.00
Permit No. Tax Folio No.
State of Florida County of St.Lucie
The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statutes,
the following information is provided in this Notice of Commencement.
Legal Description of Property:(and street address if available):�hL I�;ztVo-)"O T $ �L V,: rT
S Z T" rc �I .1 � .� �JG�� P -1 2 i EcCC EL--5 49 R2-
General description of improvement:
Owner information or Lessee information if the Lessee contracted for the improvement:
Name -y V, Vs C(1SCi C
Address e, e .r(z 7,�, io-D P y-h�2n
Interest in property: C. vl�v--;,)
Name and address of fee simple titleholder(if different from Owner listed above):
Contractor's Name: A n q Slo 6-\
Contractor Address: O Ct—'mS Phone Number: a0
Surety(if applicable,a copy of the payment bond is attached):Amount of bond:$
Name and address: Phone number:
Lender Name: Phone Number:
Lender's address:
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section
713.13(1)(a)7.,Florida Statutes: 1� S
Name: M(\e- � c n �- Q i N& 0 Phone Number: Co 31 - I) �-/ e
Address: 6 O q C fN tv U N S '!� (Z- S;i (\i
In addition to himself or herself,Owner designates of to receive a copy of the
Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes.
Phone number of person or entity designated by owner:
Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the
contractor,but will be 1 year from the date of recording unless a different date is specified)
WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,FLORIDA STATUTES,AND CAN 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 COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury,I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of
my knowledge and belief.
rJyi-)I PpA
(Signa re of Owner orlessee,or Owner's or LesseLfs Authorized Officer/Director/Partner/Manager
(Signatory's Tit /Office)
T fore ;ing instrume was cknowledged before me this day of�201�,
0 i as • b�l � for �t Lou-,.
a o ers j' Type of authority(e.g.officer,t ustee) Party on behalf of whom instrument was execut
l
� Personally known_or produced Identification
Signat of Notaryublic-State of Flori ) ,e MICHELLE SKIBIK
( ,.Type,or Stamp[Commissioned Na dl fAry Public,State of Flog Type of Identification produced
Commisslon#FF 100514
My comm.00es Mar.11,20tS