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HomeMy WebLinkAboutBuilding Permit Application r �.kY y,.:x� ?s' s" , z yy� 2 x; ✓� 'cyrifi Ta � ry°��,� �� Y� ya .��a � DESIGNER%ENGINEER. Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: l Address I Address: City: I State: City: State: Zip: I Phone: Zip: Phone FEESIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: —Not Applicable Name: Name: Address: I Address: City: ( City: Zip:: 1 Phone: Zip: Phone: (:certify that no work or installation has,commenced priorto 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 comult 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 BuildingCodess and St.Lucie.County Amendments. The following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory st iuctures,swimming-pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use MIARNINGfTO OWNER:Yourfailure 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 your Notice of Commencement. y zn' s _Signatureof Owner/Jesse Agent Sig, ture of ontractor/Liceme'Holder STATE OF FL DA S Al E Of fL0 A COUNTYOF �^v -Q +� ,. COUNTY IF The forgoing instru ent.was acknowledged before me The forgoing instrument was acknowledged before me this II day of 20I-L—by this I day of t zi~ 20 i) by {Name Of:person acknowledging) (Name of person aeknowled g)' (Signature Of Notary.Public=Sta e' f Florida). (Signature of'Notary Public-Stat of Florida.) " Personally Known: OR Produced Identification Personally Known OR Produced Identification Type of lden`tifica.tion Produced Type of Identification Produced Commission No 3 `��'�a Ikf,,(Seal)+lgPthF`Spears Commission No t r, wooer Spears AA CCCC,,ttc [ `rr��yypp�� .., r �� irVfti(Yti3JiVi�Ji•F242393 .�j i - ?y 20yg '• Col m41S51Gt 3ff242383 _ Zflt9 dVjW,,AARGiv 0 AR � rF V�VV'N:NAAuHidUTARY.CtttA Revsed.07/15/2014 REVIEVt1S FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW BATE ;COMPLETE. INITIALS i ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /_ Date: ((J �/ Permit Number: �(p 0 toyr?y(_ I 1P 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 PRQ:POSEDIMPEROV�EMENT LOCATIOxN _t.y Address: C� C� CesL✓ A�i r Legal Description: Q1 :e�n _r'l er �►"��-� �y l 5� Pro pertyTax I#: - �- L7I 3P, Lot No. 1 Site Plan Name: Block No. Project Name I Is i X: We -I Setbacks Fr ont Back: Right Side: Left Side: DETAILER'iDESCRIPTION'O'F WORK 19�. �v;v,y� �e� ���5�����r, �-�� �•-�� w/ I << �} gsfe CONSTRUCTION INFORMATION , Additionalwor toe nertormed under this permit-checK all appy: HVAC 0 Gas Tank []Gas Piping _Shutters E]Windows/Doors�-Er1CSL Electric 0 Plumbing Sprinklers FIGenerator Roof Total Sq. Ft of Construction: S . Ft. of First Floor: Cost of Construction: $ S lc)D • C)C1 Lltilities:n Sewer E Septic Building Height: OWNE�R�/LESSE:E YCONTRgCTOR ,.. , Name kl Narne: C) ��'►'� Address: Company: Sti ri EX d� City: �©��- Stater Address: NQJ) ''QPD�) ,­0C• S ��► Zip Code: Fax: City: ri � r� \�PQ�e�•- State: Phone No. ('1J'0Zip Code: e-131- 2� Fax: E-Mail: Phone No. Fill in fee simple Title Holder on next page (if different E-Mail:CJ ��\ QD�A from the Owner listed above) State or County License: 1, i If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 'h I �""��'-•-w- Y {.�"�+- � ,�,k�' ^W f::7'der.:�",' 1k`rs3'� "k�, "oaf:=gym h,�€"^3,�"�".a-k S�i:�1:� .��a4+".�-s..7 4.=:��� d...,',s� ",` � it 'a',t�4'`.,��"'r r �w °''�.��r.' t ��+ '-'=1 DESIGNER/i NGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: I Address: City: State: City: State: Zip: Phone: Zip: Phone: I FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address:' City: City: Zip: I Phone: Zip: Phone: I 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 commencin work or recording our Notice of Commencement. v S _Signature of dwner/Lessee/Agent Sig ture of ontractor/License Holder STATE OF FL DA SATE OF FLO A COUNTY OFyr.n `�1 ,,1��v�. COUNTY OF 0011_^� The forgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me this day of 20I-Lby this I day of 20 by C.� I (Name of person acknowle ging) (Name of person acknowled g) AQ6��_ . D_d*_)0'I?\_,1'__1� (Signature of Notary Public-State f Florida) (Signature of Notary Public-StatFo Florida ) Personally Known��R Produced Identification Personally Known��OR Produced Identification Type of Identific I tion Produced Type of Identification Produced ,,a�a�,, th S Commission No.I' oL- `�+...�d�.,(Seal)I ie2. er Spears Commission No lemNer Sp 'f= COhue1;SSIUN FF242393 -- ears (Y,PIRES:!unt 21,2019 ��'�% 001,,MISSION®FF242393 1 2019 c' ,AAa(iiV 0TAR = 'v.;�OFf�.� WY�W VJWVv.AARuNN0TARY.G0M Revised 07/15/2014 , ,....... ''%,,,,',aFF`����S' REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS I i y