HomeMy WebLinkAboutBUilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FORAPPLICATION TO BE ACCEPTED / (�
Date: 3 &116 Permit Number:
RECEIVE®
A OCT 21 2016
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: 'P-e,�
KIM
ROUE MINT L®CATION: .
Address: 'Z2 >� G_ l sot AVE7- * Vc>rL�'e_ FL_ 3
Legal Description:
Property Tax ID#: -3 50 C " C")0 Z 0 000 /2 Lot No.
Site Plan Name: Block No. �
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED 0 E&SCR�IPTIO 'OF 1N0
c.UU rU�
CQN:STRU�C�TI,O INFO I\/IATI:O'N:
Add itiona I work to be pertor.med under this permit-check a -.t at appy:
Mechanical _Gas Tank -Gas Piping -Shutters =Windows/Doors.
Electric _Plumbing _Sprinklers Generator _Roof
Total S4.'Ft of Construction-. Sq. Ft. of First Floor:
Cost of Construction:$ ���- �L7 Utilities: —Sewer _Septic Building Height:
OUVI��ELE�S=S�E�E; , ®N�T�RA��C'fOR;
Name 4.0-, C (O rQ &YName: L.L. C o
AddrIl - Company: �. C' . `�' S 60 S1"tt�''-G ;W
City
i- 5+K U �L� tate: 1_-IAddress:F- C' - �0 x () I L
Zip Code: Fax: City lr`` �-• LLtc c e- State:
Phone No. Z Z— 4 Zip Code: U , Fax:
E-Mail: C t' a K&LL,Co phone No Z 36 665�
Fill in fee simple Title Holder on next page(if different E-Mail _ - SI(C? s- G ry
from the Owner listed above) State or County License C( [5 b0 T
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEM1ENTAL CONSTRUCTION I LIEN LAW ItOINS
:
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 thepermit 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
befor first inspection. If you intend to obtain financing, consult with lender or an attorney before
com,rnencirkg work or recordinp,vour Notice of Commenceme
19
Signat ner/Lessee/Contractor as Agent for : r, Si atur of Contractor/License Holder
STATE OF FLORIDA r` STATE OF FLORIDA +�
COUNTY OF COUNTY OF d7'• o�,/�Gtil� . N.1
y=
The forgoing instrument was acknowledge before n -do o The forgoing instrument was acknowledged efore a"
this-Of da of /�{ ,20 (b a m� this da of �" 20l �b
y y �M�q y — y
w�= 2 An
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17
Us ALI%- au-1; (2,
e of person acknowledginga e of person acknowledging)
�J N C
t0�
(Signature of o ary Public-State of FI rida) (Signature of Not r Public-State of Florida)
Personally Know OR Produced Identification Personally Known' OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Te—v.7/2014
n
Planning&.Development Services ASBESTOS NOTICE
Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce,FL. 34982
Phone:(772)462-2172 Fax:(772)462-6443
Asbestos Notice to Contractor
October 21, 2016
J C BANKS CONSTRUCTION LLC
JULIO BANKS
6215 ARLINGTON WAY
FT PIERCE, FL 34951
RE: Building Permit Number 1610-0309
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.
O
Signature
/D 2 / 2--o / �p
Date
10/21/2016 11:15:45 AM