HomeMy WebLinkAboutDEMOLITION PERMIT COMMERCIAL a
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l i
Date: `� �� Permit Number: DIGI Oy I
n$D1fin+
4 V
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CommercialResidential
PERMIT APPLICATION FOR:
RRQPO$EP IMPROVEMENT=LOCATION_
Address: 3.3oo N. A I-i• P t r tzC':
Legal Description: pEP9E12- 1741�-{Z(41
Property Tax ID#: 2-2-0 c 0 00 1 D Uo� j Lot No.
Site Plan Name: Block No.
Project Name: A-T'L �J Av`( l� l�1 J--LU-5 u,r-t.
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
_. r
t 12 Wil}-tov At- p r- >LJ QQ 9 6K-Q-I,uG ev T6-p-to K L44X33
PR-AAt-tom lv A-1-L- + A-C- 05T. C iL.t.4lG C5 6:roAJ o )A---I
O
CONSTRDCTION-INFORMATION.
1�
Additional work to be performed 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: 12-00 Sq. Ft.of First Floor:
Cost of Construction: $ ��� — Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE
CO:NTRACTOR::
Name �cZLIVAQ-r 5�L Name: ,:f— 'IST
Address: 3DD • .4 (A �tv5 Company: c/RJ51- ( 6AJ,57',�UC-7-/DA) (Q.
Cit1 op-C4% State: Address: 5— 6,,�-Mp 7-
A4-,-U LAI ,
Zip Code: 34 cI LN _ $SLFax:'`1-l.Z -Sq S - EW? City: r--r. AG-R-C,— State: FL_
Phone No. `l"IZ - Jr9 5-5�' 4-S- Zip Code: 3q 78 Z Fax: -i
E-Mail: a 5 v%A06&L)M OrCi Phone No `Z-7Z - IL& I- f55-1-
Fill in fee simple Title Holder on next page (if differ nt a . Lcr-.�
from the Owner listed above) State or County License
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:
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 lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature Owner/Les a/Contracto gent f Owner Signatur of Contractor/Licse Holder
COUNTY OF S1 E OF F O�`CA. x—%31 a COUNTTE Y en
Y OF OS�l . r—U-�k C
The forgoing instrument was acknowledged before me The for oing instrument was acknowledged before me
this day of,_5 20 k6 by this day of 20 by
�-cc,eti � � 1� �8..rt\cS
Name of person acknowledging) (`(Name of person acknowledging)
I \ C 1
(Signature of Notary Publi State of Florida ) (Signature of Notary blit-State of Florida)
Personally Known R tfEa tido ;, Personally Known OR Producedenti leatio�tr"°
Type of Identif cati public state 2016 Type of Identification �� NNA GI�E��
µY1PU0��, NotatV ices Dec 16, Yp �, ` ,„ DEA State of Florida
Produced L,; �+;. Exp EE 8g8765 Produced �- L-, .i Y PU % cy Public 56 2056 h
r e t Dommissionl#tonal N As `I =o °: Expires Dec
r MY Comm• EE 858761
Commission No. f�c�. _'j ;`�8onaedS(��'I� r"`s' ' Commission No. #oval Nota�Y Assn
F iiii.0 C.v ytBOFf��. WaedZht 9_
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
Planning:&QevelopmentServiceg ASBESTOS NOTICE
Building&Code.Regulation Division:
2300 Virginia Avenue
Fort-Pierce,FL 34982 ..
Phone:(772)462-2172 F4x:(772)462-6443
Asbestos Notice to Contractor
July 18, 2016
CRIST CONSTRUCTION COMPANY
CRIST JAMES ANTHONY
4365 GATOR TRACE LN
FT PIERCE, FL 34982
RE: Building Permit Number 1607-0381
It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department
of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal
law.
Signature
l
Date
7/18/2016 3:15:46 PM