HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S, ,N, �q� Permit Number:
RECE14• -D AUG 16 2015
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:
Pill Ml
�/EMENT L®CATION:
Address:
Legal Description:
Property Tax ID#:-I-/33 - :5"6 / -0�2./ -dO6 - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D'ETAI�LED D'�SCRf PTION OF 11V®R!K:
��,..�.i,c..� p�cc�� c v.� LJ � K � c•:�S G-.1� �ti ✓ �F�7�1/�-�"-� l„/G.- l I
Q'SSTRIJCTI- N INFORMATION::
Additional work to be per orme under this permit-check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
—El ectric _Plumbing _Sprinklers _Generator X- Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
1[0'W�'N�E:R/tom E1ll: , C®�TO
III
Name-. eg-+�, Name: -443� C� M
Address:" SI �-� Company: -T
City: L/-ems f�7 Stater/ Address: 5-ts- 'j,G'f" rte. cs�
Zip Code:329 L k Fax: City: (/-ems State: �!
Phone No. 772 3 5-9 74 32 Zip Code: '32. 1 CS-- Fax: 772
E-Mail: L' dvi 5- '--74 -L c> I . Phone No 772 35-Y 7e 3 2-
Fill
Fill in fee simple Title Holder on next page(if different E-Mail cz_o If. �-�-
from the Owner listed above) State or County License G ! S?a 7
Y
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION L1fEN LAW INF®R+MATIO;N.:
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 of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 'S k- Lyc COUNTY OF `5 r.
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
`
this % day of C � ,20 Q) by this \G day of `6 c 20\Co by
\•M O�t�n V C O C,~41 fN
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary P blic-State of Florida) (Signature of Notary P lic-State of Florida)
Personally Known OR Produced Identification=-q Personally Known OR Produced Identification ,.t
Type of Identification N Type of Identificationvl
Produced L— �C^ �,�'rnEPN"IPr' � oft�ncida Produced r,v ' " pEANNA �tvENS
State lorida
�;�•, Notary Public res pec 56.bp16 `'"Y'P'Lg(c Public esaD of F 2056
Notary. ec 56,
Commission No. pomn(-S��a�)yp EEg56r pSsn ` Commission No. 4 _My Gom(�� p�' EE 856761
== V y commrssw tionalClolary Gommrssro+# al Notary Assn.
gh
djhrouNalion
", ya a Sonde
REVIEWS FRONT��" ZONING SUPERVISOR PLANS VEGETATION—' SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Te-v—. 7/2014
Z�
Punning'&DevelopmentSeivices � ASBESTOS NOTICE
BuNding&Gode,Reguiation Division
2300.+Virginia Ayenne.
Fort-Pierce;FL 34982.
Phone:(%72)462-2172 Fak:(772)462-6443
Asbestos Notice to Contractor
August 16, 2016
CoNp,
T C ENTERPRISE OF THE TREASURE COAST INC.
TIMOTHY H CONN
515 46TH CT
VERO BEACH, FL 32968
RE: Building Permit Number 1608-0316
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
Date
8/16/2016 1:47:08 PM