HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7 Permit Number:
t5miaing rermn App icatian
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 349182
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential v
PhKMI I A}'PUCA I ION FOK: To Select from dropbox, dick arrow at the end of tine
I
I'I OPOSEU IMPKOVEMEN I LUCAI ION: _J
Address: 78 3 W h I b cs I_ N
Legal Description:
Property Tax ID#: 3 U L 7 D L OQ�8 -000 —' Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DI TAILED UESCKIPI10N OF MKK:r F I 4 Ton P J q 10 KW
14 Sf-S9-
J.knnox d d raL he,ve co.1 ava-;Mole uMi 01 va LS G05_�
CONSTRUMON 1NFORMATIO.W
AcIditonal work o e rm underd is perm —check a apply.
EIHVAC F]Gas Tank []Gas Piping 11_Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers l Generator �.t Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ `�5 fJ s Utilities:Q Sewer 0_Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Narne l,e.l,wa E Donna + t�,,l and W SQint- L-aure r L Name: G U eT l S ,Sq a mo n S j
Address: 780 W kkl t. Ibis 1-n Company: &o-ro m A , r S,, S t ems
City: Vo a T S T I.U c L e. State: �� Address: 14215 S E �A I I r e f R Q i
Zip Code: 34g5 a- Fax: City. FD PLt St• L uci r— State: ��—
Phone No. 3 3$` )6 4 y Zip Code: .14-g52 - Fax
E-Mail: Phone No. 7`1 'y 3 S - 3 2 31
RlI in fee simp le Title Holder on next page(if different E-Mail: C u s t i r- s -, s a o 1 c o
from the Owner listed above) State or County License: G c 5[ 8 10 i
i
If value of construction is$2500 or more,a RECORDED Notice of Comrncnemwnt is required.
SUPPLEMEN IALC:UNS I RUC IIUN LIEN LAW INLUKMAI IUN:
DESIGNER/ENGINEER: —Not Applicable I MORTGAGE COMPANY: _Not Applicable
Name: i Name:
Address: Address:
City: State: City: State:
Zip: Phone: ; Zip: Phone:
I
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
— i
Name: Name:
Address: Address: i
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation hzs 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,by laws or and covenants that may restrict or prohibit such
structure.Please consult with your Home owners Association and revikv your deed for any restrictions v-jhich 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 rlonda 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,v.,a'Is,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 recording your Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent;or O:vner ; Signature of Contractor/License Holder
STATE OF FLORIDA „ , j STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument:vas acknowledged before n e l The forgoing instrument was acknowledged before me
this 11C day of SP y 20 1 by this day of ,20 by
C LI RIni), (c.fI%r1 5 �i4fT1yi)Gf1
(Name of person acknowledging j (Name of person acknowledging
'V
(Signature of Notary Public-State of fiorf_a} ! (Signature of Notary Public-State/of of Flo
Personally Known ✓ OR Produced Identification Personally Knoyvn " OR Produced Identification
Type of Identification Produced Type of Identification Produced {
ism
r�CHRSTNE a J�1 052 57�Commission No-
/1 G 0 51( � .
* * MY COMMISSION#t GG 052546 _ _" )21
c SIRES:Aped 4.2021 AV3hv}�j
BorWed TTvu budget IataN Satwes r:••= --EHR B ENGLISH-
o►re # * My COMMISSION#GG 052W
Reti-i sed G;/15 i?G 1$ �� EXPIRES:April 4,2021
REVIEWS FRONT ZONING SUPERVISOR i PLANS VEGETATION SEA TURTLE MANGROVE I
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS i