HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J1"/1V_/7 Permit Number:
nuiliaing 1 ermit 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
PEKMI I AI'NLICA I ION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMEN I LOCAI ION:
Address:
Legal Description:
Property Tax ID#: ,Y3A 7- 7,04-C4i) Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DE I AILED DESCKIN 110N OF WOKK:
CAAnsc_ �a' I-11ce /Z>� Liltc /o h�
S�sC-f,,,�E-�, ,2�('�� /6.icc( C��ansc �✓� L//tC /Z°' L/li C_ S �Z'L/
CONSTRUCTION INFORMATION:
-Additiq;aW wor 1_6 be-Terormed un3er thispe�mit-cFe-c a apply:aHVAC as Tank E]Gas Piping _Shutters Q Windows/Doors11 `
Lam'
Electric Plumbing Sprinklers Q Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 7 Utilities:0 Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name�c�u�%�'iZ/0i7S P�d7izx /�+✓ Name: Cur"Tl < SArZtE•Acel"
i
Address: J/—V 60dl 9r17 Company: Cu i s At A Si, s t e,11
city: C o l Lc m 6 Lib State: C. j4 Address: ! 15 S E !! «G-'e r ee rt �� r" j
Zip Code: ` 3 a3 Fax: City: ( %� r S t. L uc e- ✓ State: f
Phone No. l�' (�7Q- . Zip Code: J'tg152.- Fax: "PU- =3S-+
E-Mail: C� JJ Q I-I 1 u)4 V ( CL Q t y\c v h"L Phone No. �`�� 3.3 5 ' 3 2 3 2- j
Fill in fee simple Title Holder on next page( if different E-Mail: C u S t cL I i- 5 y s Gc C
from the Owner listed above) State or County License: 51 ,F (C i
i
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUY}'LtMENIALt;UN51KUC:IIUN LIL.N LAW INt-UKMAIIUN:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name: j
Address:_ Address: j
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:
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 exemptfrom undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARN ING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice fo r
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 rec . ding your Notice of Commencement.
S
Signature of Owner/ essee/Contractor as Agent for Owner Signature of Contrac r/License Holder
STATE OF FLORIDA / STATE OF FLORIDA ,
COUNTY OF �� ,(.IJC'i e COUNTY OF �f (,C/�/-�.
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this %I/day of A 20 L7by this day of A a y' 20 _LJby
Liu r b s .51t m Morl s, C�u IZT► S Jn rn M0 rx S
(Name of person acknowledging j (Name of person acknowledging) i
(Signature of Notary Public-State of Fi a) (Signature of Notary Public-State/of Flori j
Personally Known 1_OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced /,/ � Type of Identification
�CProduced
C/J
Q S 7 b r o (71 yl c(✓`1 �'' ° Y'W�'c GNktSTit;M:.' •15H
Commission No. � ai,� cHRIS7tNE B ENf (�toiissiOn No. try.'� 4525{6
MY COMMISSION 0 GG 052545 )21
N +; EXPIRES:April 4,2021 r r y 3arvlu!
.'`fQPtbO�� Bantled Tivu Budget Notary Sarvieee to CHR BEN iSH
Revised07/15/2014 * * MY COMMISSION 0 GG 05250
-~hi EXPIRES:April 4,2021
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REVIEWS FRONT ZONING SUPERVISOR { PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW i REVIEW I REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS i