HomeMy WebLinkAboutbuiling permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /40 -6Z 117 Permit Number:
dUiialing Yermil Applicavon
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 APPLICA I ION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPKOVEME.N I LOCAL ION:
Address: N E .T/(.Lt6_-&)0 /C �
Legal Description:
Property Tax IDt#: �j7/ �'�7 (Cj ��Csj `�j�'�- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DL I AILED DE -SCRIP I ION OF WORK:
CAR rs c- o d -c 3 k-1
CONSTRUCTION INFORMATION:
L-A'
1 wor cyto -5 rtor=mee --under this perm - chF6 a
MHVAC f]
Gas Tank ❑Gas Piping Shutters Windows/Doors
11 Electric E] Plumbing Sprinklers FI Generator F]Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost Construction: $ �3 Utilities: Sewer Building
of _Septic Height:
OWNER/LESSEE: CONTRACTOR:
Name l
Name: Cis T (� ,S-A r�tty\C r, S —
Address:
Company: Cun?o m A , r- S, -r S t ei'l, t ru c;
City: PC, nt .Crt kuc t State:=i-
Address: 1615 S E ��; I i (i G �� r ee i1
Zip Code: J q 4 83 Fax:
City: IPO RT Sr . L v c i e- State: rL
Phone No. G78`g6g9 b
Zip Code: `F452- Fax:
E -Mail:
Phone No. T -i 3 3:5- 3 2 3 2
Rif in fee simple Title Holder on next page ( if different
E -Mail: C u .s t Ca I r s y�� Cc c' i C c. vrti i
from the Owner listed above)
State or County License: it
If value of construction is $2500 or more, a RECORDED Notice of
Commencement is required.
SUPPLEMEN IAL CONS I RUC ION LIEN LAW INFORMAI ION:
DESIGNER/ENGINEER: — Not Applica
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Ad d ress:
State: City: State:
Zip: Phone:
Not Applicable BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
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 recofding your Notice of Commencement. n
C�
Signature of Owner/ essee/Contractor as Agent for Owner Signature of Contrac or/License Holder s
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF �� ,C U (? j E COUNTY OF_ �_Fz
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of Oe't-d 4-) , 20 Eby this rQ day of De h &4) 120 /7 by
- Liu r b� �
S �'14mMOnS (4arZ_r1 S 9nmM0n,5
(Name of person acknov✓ledging ) (Name of person acknowledging)
(Signature of Notary Public- State of Fl e
a J
Personally Knowny OR Produced Identification
Type of Identification Produced ////
Commission No. V 6 1a YC
Revised 07/17/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
CHRISTINE B
(Signature of Notary Public- Stat o4FIoriZ���
i
I
Personally Known OR Produced Identification
Type of IdentificationProduceed
*�� ^�* GH�R
r?i;;�
1n15510n NO.t4 n ( o 5. �� try.G 055 :> * EX]21
1rPIRES' 1t 20'21 a i C. I
w1ed 1h�""'
U WNg6'7S K ��M--•^��n�G�G1R7
EXPIRES: April 4, 2021
SUPERVISOR 1 PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW