HomeMy WebLinkAboutCCF06202018_00000ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
L Permit Number.
Date: �'
•
duiliairlg Yermix Applicavon
Planning and Development Services
Building and Code Regulation Division
23oo Virginia Avenue, Fort pierce FL 349132 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PEKMI I APPLIC;A I ION FOK: To Select from dropbox, click arrow at the end of line
YIjOpOS_EU i_MPK{3V_EMtN I LOCAI ION: _ -
Address:
Legal Description:
Property Tax ID #:
Site Plan Name: _
roe- a�87--DDD
project Name:
Setbacks Front
Back: ___ Right Side: Left Side:
UEIAILED UESCKIPIION Ol- WOKK:
CONSTRUCTION INFORMATION:
ona woro e er rme under
❑HVAC Gas Tank
11 Electric a Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
OWNER/LESSEE:
this permit — GI
[]Gas Piping
0 Sprin klers
Taapp Y:
_ Shutters
Generator
Sq. Ft. of First Floor:
jlo
Utilities: 0 Sewer l=.1Septic
Name R6&1 � � /��2ci� fchrn��n do-
Address: ►���.2 ��"'"� Q� r�
City: 1')1(L st �� i State: rG
Zip Code:� �Q ����x•
Phone No. cP��1,
E -Mail:
R11 in fee simple Title Holder on next page ( if different
from the owner listed above)
CONTRACTOR:
Lot No.
Block No.
FWindows/Doors
MRoof Roof pitch
Building Height
Name: Cil VC. -11 S LAttkmC(I
Company: Ct,lSTbm Sus
Address: I 'i5 ISE
C{reer1 l
O P --r St . L. oci � State: rt--
City: t 345 Fax:77J- J 3 5-19
Zip Code:
Phone No. °i 3 3:5- - 3 2 3
E -Mail: C u s t i s Cc C' C c. an
State or County License: A cc? 519 to
ff value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENIALCONS IRUC I[ON LILN LAW INFORMA I[ON:
DESIGNER/ENGINEER: _ Not Applica
Name:
Address:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: _
Address:
City: —
Zip:
one:
MORTGAGE COMPANY:
Name:
Address:
City -
Zip: Phone: _
BONDING COMPANY:
Name:
Address:
City:
zip: Phone: _
Not Applicable
State:
_Not Applicable
I certify that no work or installation ilas commenced prior to the issuance of a permit.
St_ ucie CountV_makes no representation that is granting a pem,it will authorize the permit holder to build the subject structure
ttt ucIt is turenPlease consult any
}our Non le Home
O ��ers Association Assocules iation
ew your deed aws or or any covenrestrictions whimay chtrict or may apply. bit such
In consideration of the granting of this requested permit, I do hereby agree that I will, in all. respects, perform the work
in accordance vrith the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The follmk ing building permit applications are exempt from undergoing a full concurrency review= room, additions,
accessory structures, swimming pools, fences, v..#a`:Is, signs, screen rooms and accessoR, 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 recording your Notice of Commencement.
Signature of Owner/`_essee,'Contractor as Agent -i or O-,ner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument :was acknowledged ' bef are me
this 9 r day of i= - 20, by
c'.
(Name of person acknowledging j
(Signature of Notary Public- State of Rl. r a }
Personally Known OR Produced Identification
Type of Identification Produced_ —
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this _ day of 20 /,by
(Name of person acknowledging) l
(Signature of Notary Public - Stat of Flork
Personally Known OR Produced Identification
Type of identification Produced
f YC CHRISTINEBE0W§fhmis<
Commission No_ G 6 C �� <' 4x!% 4c o5251
MycoMM1SSI0NttIGs
EXPIRES:Apd 2021_
----- --- 9 loaded TNtu Budget Netaq Services
'dor re°
Re�,-ised 07J/1:_V2014
REVIEWS I FRONT ZONING ;SUPERVISOR PLANS
COUNTER REVIEW RE
EW REVIEW\REVIEW
COMPLETE
INITIALS
00 pu",�c CH IST -we 7. 11a
N o. L7 �- �7 n 4) t."'
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4 ArP -- CHRRYrtV> =BENGLiSFi--
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yF * MY COMMISSIONI! GG 052543
EXPIRES: April 4, 2021
VEGETATION
SEA
LE MANGROVE
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