HomeMy WebLinkAboutBUILDING PERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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
PERMIT APPLICATION FOR:
Commercial ---- Residential £ 7
PROPOSED INPROVEMENT LOCATION:
Address: ·� '£ ,an�v 1).., 1 Y(Yt �+ Lu C I e_ , fl 3¥iS2-
Legal Description: �'fj -5\u - t:5:(ot) - CDD - Di (B).Ke\ \ DJ
'Q\"ev ?ovl(__ -Unit 2 - BLk-l \ 'l-ot-4 Ca:x:up 34 /22N)(� 31�- \ \Clz)
Property Tax ID#:-------------------------
Site Plan Name: tf-\C \::t:Qd
Project Name: fl\(' J ±bro
Lot No._4_,___ __
Block No. \ \
Setbacks Front ---- Back: Right Side: Left Side: _
Mechanical
Electric
Gas Tank
_ Plumbing
_ Gas Piping
_ Sprinklers
Shutters
Generator
_ Windows/Doors
Roof
Total Sq. Ft of Construction: _
Cost of Construction:$ 4?Ei) .16
Sq. Ft. of First Floor: _
Utilities: _ Sewer _ Septic Building Height: _
Name 5:--,c±JrDci
Address: 8rn:: �\IXYJCLV 8v-
City: fcvt ()+- \AC1G
Zip Code: �:52 Fax: _
Phone No. _
E-Mail: _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: "'loc:B Po l/0 l Y\,Q.)
Company: A Ip{'Y\ o:?c,hl2 � 'R.cvJ?
Address: 2:J::Ji N t:1C\Ytt.v � K Vd ':\OL
City: MC\u::uRIY? «! State:__EL_
Zip Code: 32-CJ?fS Fax: 32.l LQ3K C():&Q
Phone No c.,,3'L\ l,Q_:Ui ·2�'2fl
E-Mail �(f CW.S\:@�vtc,{),
State or County License 1J C,B(Y'\
State: FL-
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
_ Not Applicable _ N9t Applicable DESIGNER/ENGINEER:
Name: ------------------� Address: ------------------ City:------------- State: Zip: Phone _
MORTGAGE COMPANY:
Name: -------------------� Address: ------------------� City: State:
Zip: Phone: _
_ Not Applicable _Not Applicable FEE SIMPLE TITLE HOLDER:
Name: ------------------� Address: ------------------ City: _
Zip: Phone: _
BONDING COMPANY: Name: _
Address:------------------ City: _ 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 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 len or an attorney before
commencin work or r r in our Notice of Commencement.
STATE OF FLORll"ld
COUNTY OF ,'.3r:: \.\AL \e,d
STATE OF FLOR§t:.
COUNTYOF , \MC\�
The forgoing instrument was acknowledged before me
this JL day of �� • 20.llt?by
{Name of person acknowledging)
The \qrgoing instrument was acknowledged before me
this ll.-day of D:'£l� , 201.Lp by
�� \o \y t>}:O'Q)t s
Personally Known :--"'X�_,�O�R�P�ro�d!!u!!!c!!!ed�I �!!!'t�'f�.c!!!;t�io�i=="'=-'· '==ii
Type of Identification --1�trtt,, STEPHANIEBROOKS J Prod u ced --'lfl<f""'':·�· �··..,,t'�1 __,,M'-'c::'Y COMM!SSION # FF 217128 �i/ ... .;�f EXPIRES: April 5, 2019
Commission No. ---�-'·,�,,9;;;f"";.i;"'';;;'' ;;;;;;;;;8;;;on;;;de�1�·u 1;1.' tl..ary.;;P;;;;ub;;;;lic.;;;U.;;nd;;;;erw;.;·rit;;;;ers�
Personally Known X OR Produced Identification _
Type of Identification .,---�J�\-,'.�'f���---,,!!!!!!!!!!!!!!!!!S!!e!TE!!!!!P!!!HAN�IE!!!!B!!o'!'RO!!!O!!!K!!!S !!!!!�
Produced ·.;'/K·�;� MYGOMMISSION#FF217128
d\;j;:�W EXPIRES: April 5, 2019
Commission No. ---i,j�-·f. .. ,,9fii;;; .. l;;;t,,•;;;' ;;;;;;;;Bo;;.nd;;;;ed;;;;T;;;;hru;;;;;�;�;;;;;i��;;;un;;;;de;;;;;ra;;;;;·nt;ers;:J
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
NOTICE OF COMMENCEMENT
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): � 'RtC)l't'X)...V Dr , t'DVt �kLu. C I.(? FL f,l.,rf.v:\?llrt..-Uact: 2- a1L1 I I Vl::4(rrc..p3V2:2 .. N)(Q2.31Bv-1 \q2) ?:!052...
General description of improvement: it:E,:tl\ \\ ]3\' 0£- le' 'v\Jct)6 Kb(f) W l l '30. ,\t> 1
Owner information or Lessee information if the Lessee contracted for the improvement:
Name E'P-tl lliud ·
Address ,3 Q? Pimiu-- De , fur\- s+: \ 1 J r I c H 3ACI 6 2 Interest in property: -��� ... v.__ _
Name and address of fee simple titleholder (if different from Owner listed above):
Contractor's Name: �VI bv: R ,h l e .,.__ Rei 1 \
Contractor Address: ·f-rii N \::YlYbQv (.A,iy p\\1cl. M(b ��hone Number: 02d le,3{ O � J I 32-'13'8
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 Secth
713.13(1) (a)7., Florida Statutes:
Name: -·---�--------------Phone Number:------'----'---'- Address: _
In addition to himself or herself, Owner designates of to receive a copy o
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·
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.
r Owner's or Lessee's Authorized Officer/Director/Partner/Manager
(Signatory's itle/Office)
The foregoing instrument was acknowledged before me this � day of� , 2oli(?
By ty \{_, ·\-:\a.xi as QW D� for _
Name of Person Type of authority (e.g. officer, trustee) Party on behalf of whom instrument was executed
,•"�"··· STL·· ·\itE 8\-iOOKS Pei on ally known_·_ or produced ldentification_k_.
(Signatur of Notary Public - State of Florid {ff.'Jitt."- MY COMMISSION# ff 217128 � -;
(Print, Type, or Stamp Commissioned Name of Not,11rr-�l·��·�o�, ·��-�;;,;;;J�B�o�nd�;{;;f�h�i�;;:;;t�ry;.A� .. � .. �1� .. c'u;.;�O .. d1 .. !,,;;;;;·i{ • .yp�of Identification produced tktt____ I ''""''�
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4;.4'
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COVERED
CONCRETE WALK
S.33.30'00"W.
300.0u'(Pf 300.0S'{F)
BEARING BASE
30.0'(P)
� SCREEN ENCLOSURE
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RIOMAR DRIVE
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