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HomeMy WebLinkAboutCCF07182018_00000ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �- o ^ o Permit Number. • Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34932 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PEKMI I APPLIC:A I ION EUK: To Select from dropbox, dick arrow at the end of lime I, PROKISE_U IMPKOVEMEN 1 LOCAI ION: _ Address: - Legal Description: Property Tax ID #: a 4 R4 - a D© - O I`cl - 00 � 3 Lot No. Site Plan Name: Project Name: Setbacks Front Back: Right Side: DE I AILED UtSC RIP I IUN UI• WQKK: ��/- /Z � Z_lh� .� 5' �ti VS -'r CONSTRUCTION INFORMATION: J1VAC L -I Gas Tank [_ Gas Piping OElectric 1:j Plumbing 0Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ SLS', OWNERAESSEE: Block No. Left Side: ❑ Shutters Q Windows/Doors 11 Generator 1-1 Roof Roof pitch ft. of First Floor. _ Utilities Sewer o Septic Name clrxa 6RM IJterce- Address: 7,f19 MOC/ia flock W41Y city. Qoa Y S -r L, i ct e- State: Zip Code: Fax: Phone No. E -Mail: R11 in fee simple Title Holder on next page ( if different from the owner listed above) CONTRACTOR: Building Height: Name: U le -T l S FSA ri l t --A c n S Company: 0Lcs_Ta n1 • r S�4 S t e✓ s 1 we, Address: 14P 15 S E 1 f t 11 d-4 -e r ee nCity p FD R -'r 9t . L u c{ c- State: r�- Zi p Code: 3'q 52 - Fax: 77J- d 3 57- i 9 a Phone No. 171 -la- 335--313,1 E -Mail: 0 u S t& 1 r s T +_1 Cc o t C vn State or County License: G 5 [ 8 ( C) if value of mnstrucld(n is $2500 or more, a RECORDED Notice of corru mwernent is required. $14 V%2646 3*yic-.5 SUPPLEMEN I ALCUNS I RUC I ION LILN LAW I NFURIVIA I IC)N: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address:Address: State: City: State: city: Zip: Phone: Zip: Phone: BONDING COMPANY: Not Applicable FEE SIMPLE TITLE HOLDER: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: I certify that no work or installationilos commenced prior to the issuance of a permit. St- Lucie Countymakesno representation that is granting a permit kt-jill 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 AssocicAion and revie-j 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, perforni the work in accordance vrith the approved plans, the Florida Building Codes and St. Lucie County Amendments. The folio,,kling building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, %va'ls, signs, screen rooms and qccessoR, uses to another non-residentiai Use WARN IN G 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 Ow.-lerl:-'essee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDAS, COUNTY OF u 6; i COUNTY OF The forgoing instrument :vas acknowledged before me The forgoing instrument was acknowledged before me this s day of Tom 201y by 1 this I day of Tvty 20 1 8 by e�, U C a I (Name of person acknowledging (Name of person acknowledging) . Flo (Signature of Notary Public- State of a) (Signature of Notary Public- Stat of Floor Personally KnovulnOR Produced Identif cation -wrt Personally KnoOR Produced Identification I Type of Identification Produced Type of identification Produced - I 00 PU" yp CHRISTINE B ENWlft mission No. 0", Commission No. In 6 MY COMMISSION At FG 05M . Apd 4. M1 W EXPIRES: Baisdiiid Thru Budget NCt2N Services o► toMY COMMISSION AIGG052W Re -,-iced 01'/1-:;i2014 'q WIMS: Aoil 4,2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS $14 V%2646 3*yic-.5