HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
R �
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:
Address: I ��Y-C
Legal Description: hi���,l�� S-./3�� fQ�-V✓ 15� F-�0r06k� e_D5V td FS /3a
Property Tax ID#: 14a �t Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Sta:7 N t ,3AK R,!�A t- Ce,.^ri-e- of N0y:5 v- O lDw,t,-J QaC't P.,2g�7�4
aT- 1)r�+�-� w0.y , Tu,,,, T o►nal T-11'e- e-f^7-
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eta Ori'AA< Turn etnct cnn -rh cF?- �rrt',il."nom .
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dditional work to be performed un er t is permit-check all that apply:
Mechanical —Gas Tank —Gas Piping —Shutters _Windows/Doom
—Electric —Plumbing —Sprinklers _Generator _Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:,:
Cost±of;Co nstruction:..$- 6700 , Utilities: ♦Sewer Septic Building Height:
Name dGVNNe: �;a� r.. i- ,:�: �; _,,.s�;;i . 7am -�C4D��� '12� YS
Address: 1 I ' �YC;�,� S y: A'/ == il1c ;./ i�✓ lr
City: State: Address: I LI
Zip Code:3 Fax: City: Po /'e5-'- -1,LLci Stater
Phone No. 77 1 9 Zip Code:-3Fax: `77-2-
E-Mail: Phone No. 7 -3 c)
i
Fill in fee simple Title Holder on next page(if different E-Mail: O �vs•i=e _�®YaC f�14.I Cd nI
from the Owner listed above) State or County License: 6_3 6
If value of construction is 2500 or'more,a RECORDED Notice of Commencement is required.
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:
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 considerationof 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 inspectiori. If you intend to obtain financing, consult with lender or an attorney before
commencing work orrecording our Notice of Commencement.
Signature of Owner/Agent/Lessee Q Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �� , .G COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this lj}:P�day of 20- 1_(p by this /2 day of 20 14 by
YN C::�ft Q2
- Sc - * ���
(Name of person acknowl ging) (Name of person acknowledging)
(Signature of Nota Public-State of Florida) (Signatu, q„ g to of Florida.)
�;•, ANGELA ly e
Personal) Known OR Produced Identifikation ��' Persona •.; NotarlAk �rFdentifi tion e-12—,
Type o —U Type of a, F� � �ll�o Nolo a of Florlda
„��„�� Bo Mm.Expires 30
Notary Public-State of FI da
Comm i .? eal Commission No. Bonded tlonalNo27AIQ
•Q= FF 2347 aryn.
mrfarithrojigh
of;'oP. My Comm.Expires May 27,2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 4158832 OR BOOK 3835 PAGE 2149, Recorded 02/10/2016 at 04:33 PM
NOTICE OF COMMENCEMENT
TO Be COMPLETED WHEN CONSTRUCTION VALUE EXCEEDS$2,500.00
I PERMIT#: TAX FOLIO#:3 yo —.5—o/— 06 3—Q 6 0 s
I State of Florida,County of„�LL L_c-1 e the undersigned hereby gives notice that improvement will be mode to certain real proper
and in accordance with chapter 713,Florida statutes,the following information is provided in this notice of Commencement, g
1. LEGAL DESCRIPTION OF PPERTYAND ST EET ADDRESS IF AVAILABLE):
f I► R C\y 0-Q O R� f�{2 R CP , --444 3 G $�. F
2, G4NERAL DESCRIPTION OF IMPRPVE ENT C
3. OWNER INFORMATION or LESSEE INFORMATIO (If Lessee contracted for the improvement) i
o. Nome: _So qyt Y\'c
Address: L; Pe P_ voA
b. Interest in property:
p.
c. Name and address of fee simple title holder(it other than owner):
4. CONTRACTOR:
a. Nome: 1- /1J o ' w /9) ae _ DJ C.cr
Address: 79 U -!r P.W,
b. Phone number: r
S. SURETY COMPANY(IF Applicable,a copy of the payment bond Is attached): o
I a. Nome &Address:
b. Phone number: Bond amount:
6. LENDER/MORTGAGE COMPANY:
a. Nome&Address:
b. Phone number:
7. PERSONS WITHIN THE STATE OF FLORIDA DESIGNATED BY OWNER UPON WHOM NOTICES OR OTHER DOCUMENTS MAYBE f
SERVED AS PROVIDED BY SECTION 713.13(1)(a)7., FLORIDA STATUTES: I
a. Name&Address:
b. Phone number: fox number:
8. IN ADDITION TO HIMSELF OR HERSELF,
a. Owner designates of to receiv E
a copy of the lienor's notice as provided in section 713.13(1)(b), Florida statues. °
b. Phone number: i•
7. EXPIRATION DATE OF NOTICE OF COMMENCEMENT: .
(THE EXPIRATION DATE 15 ONE(1)YEAR FROM THE DATE OF RECORDING UNLESS A DIFFERENT DATE IS SPECIFIED).
WARNING TO OWNER:
1 ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED UNPROPER PAYMENTS UNDER CHAPTER 71
PART 1,SECTION 713.13,FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY,A NOTICE OF COMMENCEMEN
I MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT WI1H YOUR LENDER OR AN
ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR.NOTICE OF COMMENCEMENT.
UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING AND THAT THE FACTS IN IT ARE TRUE TO THE BEST OF MY
KNOWLEDGE AND BELIEF(SECTION 92.525.FLORIDA STATUTES
ATURE OF OWNER or LESSEE or OWNER'S AUTHORIZED OFFICER/DIRECTOR/PARTNER/MANAGER
I.
SIGNATORY'S TITLE/OFFICE ����j,y�/ E
THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE ME THIS a DAY OF �20f(O ,8 [;
1'
FOR d-ft l
AS �tI�Y,Q:r- - --1-�
NAME OF PERSON TYPE OF AUTHORITY NAME OF PARTY ON BEHALF OF WHOM INSTRUMENT WAS EXECUTED
ZIPERSOr KNOWN OR PRODUCED IDENTIFICATION TYPE OF IDENTIFICATION PRODUCED F HY
NOTAW GNAT RE NOTARY PRINTED NAME NOTARY SEAL
�� N � TIFFANY S.NIXON
STATE OF FLORIDA NOTARY PUBLIC
ST. LUCIE COUNTY STATE OF FLORIDA t
THIS IS TO CERTIFY THAT THIS IS A Comm#EE1334578
TRUE AND CORRECT COPY OF THE Expires 10H/2018
ORIGINAL. - a
tOE E S T , LERK t C rl °'Dat