HomeMy WebLinkAboutbuilding permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I b .Q, `" I
Permit Number:
-
•
ounaling rermn Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
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Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential
PEKM! I APPLICA I IUN I -OR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPKUVLMLN I WCAI ION:
Address: 3!5Q9 V I'-pl u r"n IU -
Legal Description:
Property Tax ID #: 0g0g5 - %0,3' 00 9c> " c
oo - Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side:
Left Side:
UE I AIL�U UESCKIP I ION OF WO KIK:
CONSTRUCTION INFORMATION:
Additional wor o e er rme� un er is permit - check
all thglt appy:
❑.
YHVAC Gas Tank ❑Gas Piping
_ Shutters Windows/Doors
ElectricPlumbing ❑Sprinklers
QGenerator Roof Roof pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $ C4954 Utilities: 11 Sewer 0Septic Building Height:
OWNER/LESSEE:----_�_'----_-���
-CONTRACTOR:
Name
Name: CUVCCT(S SA6W'\Gf1�
Address: 8529 V. ht, rnt_sCJ
Company: Lts7rarK Ac, -
City: a2 rf '54- 3r i -p State: C
Address: r ee r�
Zip Code: �3 L195a Fax:
City: fro (ZT ,Sr , 1_ vc e- State:
Phone No. I11A - L3 qb - a 95.
Zip Code: Fax 77J i 3 i 5
E -Mail:
Phone No. °7 1 3 3:51- 3 3 2 I
Fail in fee simple Title Holder on next page ( if different
E -Mail: t? u a t C" i r - y $ Q o I (- & vn
from the owner listed above)
State or County License:
If value of construction is $2soo or more, a RECORDED Notice of Commencement is required.
SUYYLEM EN IAL GUNS I RUCI ION LIEN LAW INFORMA I ION:
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:
Ip: 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 that
and covenants 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 rec ding your Notice of Commencement.
s
Signature of Contractor/License Holder 1
Signature of Owner/ essee/Contractor as Agent for Owner
STATE OF FLORIDA //
COUNTY OF ,t,UC`%
STATE OF FLORIDA
COUNTY OF e/�.
The forgoing instrument was acknowledged before me
i
The forgoing instrument was acknowledged before me
this J- day of OCfObtr20 t 'Tbv
this 7 day of OC t?'Ob2r 20 E by
�I; 6131 mon E
Cru IZ rl S gYli m mo n S
(Name of person acknowledging )
_
(Name of person acknowledging)
tea
(Signature of Notary Public- State of F; a)
(Signature of Notary Public- Stat of Flori j
Personally Known _✓_ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification Produced
Type of Identification Produced
//
Commission No. 6' 6 0 5 � 1/b r ° CHRISnNE B
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** MYCOMMISSION�1
mission No. �, o S �Sy (� *� •• * IES; -a:. .:� o
0052516 rr
_ �.. . _EXPIRES.AprY
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2021 � .>
-
K Bended Thr' Budge! �y
sovic" t ••:,
Revised 07/15/2014
* * MyCMIMlsSIONS000EM
EXPIRES: APd
4, 2021
REVIEWS FRONT ZONINGSUPERVISOR
PLANS ' VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW I
REVIEW # REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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