HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J'r-oZ IO'l g Permit Number:
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autiaing rermn Hppilicavon
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)452-1553 Fax: (772)462-1578 Commercial Residential
PEW I APPLIC:A I ION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPKOVEMENI LOC;AIION: i
Address: 3 7'17 15�5 i C r I CL CIL
Legal Description:
Property Tax ID#: `70--3 "- 0151 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
IDE I AIM) DESCRIP I ION OF WOKK:
Seer- pa'C'Vr%Q c n4-- Jb KL,�, N2C eCZ�
CONSTRUCTION INFORMATION:
itionalwo-rk,,-fo-5-e-D—e-r-f6r—ir-ri-edunder this permit-check all that apply:
VAC Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric Plumbing E]Sprinklers 11 Generator Roof Roof pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction: $ y��lJ Utilities:F]Sewer Septic Building Height:
OWNERf LESSEE: CONTRACTOR:
Name t( r-C�C'(IC'l/ E Name:
Ci'�T1 �HrLti•�cnS
Address: I0305 Cl, (-:Cod 2cl Company: �'u3-ron1 A ,r- Su Stems lru,
City: State: 0 Ff Address: t4')15 S E i/t i( dG-e !areei1 fD l y
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Zip Code: U 3-�-� ( Fax: City; PU R-T St. L uc,e_ State:Phone
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Phone No. L41`1' 3y 3 `7902 Zip Code: Fax
E-Mail: Phone No. a 3 s -
Fill in fee simple Title Holder on next page(N different E-Mail: u s t ct i r s s £ Cx 0
from the Owner listed above) State or County License: R C G' 51 e (c
_..._.___
if value of construction is$2500 or more,a RECORDED Notice of commencement is required.
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SUPPLEM EN I AL C;UNS I RUC I ION LIEN LAW INFURMA I IUN:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: ; Zip: Phone:
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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 k-JII authorize the permit holder to build the subject structure
wNch is in conflict with any applicable Home Owners Association rules,byla,.vs or anet covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and revie v 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%.Ath the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The folior!ing building permit applications are exemptfrom undergoing a full concurrency review:room additions,
accessory structures,s ramming pools,fences,watts,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 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 recording your Notice of Commencement.
Signature of Ginter/Lessee/Contractor as Agent for O.vner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ��L% COUNTY OF
The forgoing instrument was acknowledged before we � The forgoing instrument was acknowiedged before me
this 6 day of 20 IX by this ,. day of PKI C� 20 / by
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• Inlnc,� � cct^TI S IT1 n S
(Name of person acknowledging j (Name of person acknot.ledging)
(Signature of Notary Public-State of For}da j (Signature of Notary Public-State of Fior'
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Personalty Known ' OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced_ Type of Identification Produced
'�Y
Commission No-f G7 fir✓ ?q t CHRISTt4EBEN"H-Imission No.
MY COMMISS104#GG 052W c:- ! )29
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Revised 0 /1_%2G1 1 � EXPIRES:Aptil4,2021
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REVIEkAJS FRONT ZONING SUPERVISOR i PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW I REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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