HomeMy WebLinkAboutRendell AppALL APPLICABLE INFO MUST BE COM
Date:
COUN-rY
F L O R t D A
FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division f
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
PROPOSED IMPROVEMENT LOCATION:
Name
Address: -768
Legal Description
L
[o� 1`74AU of IcPj
Property Tax ID #: 13o ~ 66S, 01 zbD- 1
Site Pian Name:
Project Name:
Setbacks Front ZBack: _� Right Side: Z Left Side: Z
DETAILED DESCRIPTION OF WOR
Lot No._
Block No.
CONSTRUCTION INFORMATION:
Additional work toe e orme under is permit- check a apply:
HVAC E] Gas Tank Gas Piping _ Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ '7300- Utilities: — Sewer L �J Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
Name: -e-1 41 de1-rmc'^
Address: -18oi tucl000J bd,,yIe
City: C_e
Company: Ue'-ci'4.�S Fc#-ce -' t 5 rwc.
State: F—
Address: Voo _rJ �crri�M f / ,,,
Zip Code: Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page
from the Owner listed above)
City: P-I&L State: r -4 -
Zip Code: 311K3 Fax: 177-lell - 160Y
Phone No: -'7Z- b 7of- Z3s 8
(if different
E-Mai1:z<+C'eke%,& �c�etn P fd-oo . e -v,-
State or County License: CL&.;1V rK1,3
If value of construction is $2500 or more, a R§CORDED Notice of Commencement is required.
JP LE EN,TA.:.CONSTRUCTION
LIE LAW INFORMATION:
NER/EIwG'=.N€Eta: �
_ j
Marne
Name:
Dt Applicable MORTGAGE COMPANY: Not Applicable
-�
Address:
Name:
City:
Address:
State: City:
Zip= Phone: State;
Zip: Phone:
FEE SIMPLE TITLE HOLDER:. __ Not
Name:Dame:
Applicabie
BONDING COMPANY: Not Applicable
Address:
Address:
City:
City:
Zip: P ane -
Zile Phone:
1 certify that no work or installation has Corr
St. Lucie Counmakes no representation th
which is in conflty ict with any applicable Homo
structure. Please consult with your Horne ov
In consideration of the granting of this reque
in acCofdance with the approved plans, the F
The following building permit applications ar
accessory structures, swimming pools, fence-,
WARNING TO OWNER: Your failure to
improvements to your property. A Nc
before the first inspection. If you irate
cornmel'Icing work or recording= vniir r
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF <:
prior to the issuance of a permit.
]wears Association rules,t will abylaws or andhe permit covenants that build
restrictborprohibit such
iers Association and review your deed for any restrictions which may apply.
:ed permit 1 do hereby agree that i will, in all respects, perforin the work
arida Building Codes and St. Lucie County Amendments_
exempt from undergoing a full concurrency review: room additions,
walls, signs, screen rooms and accessory uses to another nun -residential use
tecord a Notice of Commencement may result in your paying twice for
ice of Commencement must be recorded and posted on elle jobsite
d to obtain financing, consult with lender or an attorney before
otice of Cornmenc.prr,Rrit
The forgoing i nstrumAnt was acknowledged b efore rile
this day of a 20 'Lby
ern4ofPperison acknowledging )
(Signature of Notary Public- State of
Personally Known __'�k _ OR Produced
'type of Identification Produced
--- P-4-- Y� �� �
Signature of Contractor/License Hoiden s
STATE €3F FLORID&,_
COUNTY OF L
The forgoing instrument was acknowledged :before me
this �LAday of F'e'kvg,y. 24 by
(Name of person acknowledging))
i� /
(Signatur of Notary Public- State Florida 1
Personally Known X- 0 Produced identification
Type of Identifi;.ation Pr0duk@4 —
y icf�Ii.
` nr a
Commission No. ���" KIRK Affil IC a min KIRK ARI KAT2
} Jbsrri'sssi n No.fiMtS5rC1NFF044
MY COMMISSION �FFO�k4924
N �'
moi "4_
foFo�° EXPIRES August 12,201
{407}~399.0153 FbridallotaryService.com (4471398-0153 Florttiallotary ervice.com
Revised 07/1.5/2014
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REVIEWS FRONT I ZONING SUPERVISOR FLANS VEGETATION SEA TURTLE MANGROVECQUNITER REVIEW REVIEW REVIEW REVIEW
DATE REVREVIEWREVIEW
COMPLETE
INITIALS
LEGAL DESCRIPTION:
WEST 1/2 OF LOT 17 AND ALL OF LOT 18, BLOCK Z
LAKEWOOD PARK UNIT NO. 3, PLAT BOOK 10, PAGE
RECORDED IN THE PUBLIC RECORDS OF ST. LUCIE i
FLORIDA
C)
125
ST. LUCIE TITLE SERVICES, INC.
COMMONWEALTH LAND TITLE INSURANCE COMPANY
AS NOTE:
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