HomeMy WebLinkAboutCCF08132018_00001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8 -13- () Permit Number
auiliaing rermit Application
Plmtning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 349182
Phone: (772) 462-1553 Fax: (772) 462-3578 Commercial Residential ✓
NEKMI I APPUC;A I QN I-C)K: To Select from dropbox, dick arrow at ttte end of line
l'i OP05EU IMPKUVEMEN I LUCAI ION: _..
Address: 7 N i D S O Q&Ln. Oh, J14D 7 D ayLat'n. fAJU
Legal Description:
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
i
DE I AILED UESLRIF I ION Ulh WOKK:
L/f�L f=�f 1_llz 2:�
C16;ASP 0,-,- Sk i✓
CONSTRUCTION _INFORMATION: _
Additional wo o e rm un er .
is permit — c heck a app
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing 0Sprinklers Generator F]Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor _
Utilities: 11 Sewer[] Septic
OWNERAESSEE:
Nanie m rca, A,
Address: 2410 S C Ccn 'Zr 4 L1o'(
City ar'se.n �e a -C L State: FL-
T-5p
FL
Zip Code: X � Fax:
Phone No. 3 o a - � 50 ' Z904i,
E -Mail:
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name: C U r' -T yv\ c r► 5
Com pang 0LLs-ro n1 A %r SU s t ems
Address: 11p15 S 6 \,/I Il green 0 �
Po 2r St . L u c i t_- State:
Zip Code: 0-+q 52 - Fax: '77J- d 3 5- i 9 is a
Phone No. '7 I�L 3 3:5- - 3 -13 2E -Mail: u St&Ir Stir -P C4. L, C6VY_
State or County License: G o
if value of construction is $2500 or more, a RECORDED Notice of Commencement is reqs.
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SUPPLEMEN I AL C:UNS I RUC I IUN LIEN LAW INFUhMAI IUN:
DESIGNER/ENGINEER: _ Not Applicable
I MORTGAGE COMPANY: — Not Applicable
Name:
Name:
Address:
Address:
City: State:
I City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
Name:
Address:
Address:
City:
City: 1
Zip: Phone:
Z`1 P: 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 v:ill authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Ovrr,ers Association rules, bylaw, s or and covenants that may restrict or prohibit such
structure. Please consult .-jith 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 v.Ith the approved pians, the Florida Building Codes and St. Luce County Amendments.
The foll1mving building permit applications are exen-:ptfrom undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accesson, uses to another non-residentiai 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.
S
Signature of OEvner/_essee/Cortracior as Agent ; or O:vner I
Signature of Contractor/License Halder 1
STATE OF FLORIDA , , j
STATE OF FLORIDA
COUNTY OF �, U C` ! t _
I
COUNTY OF
The forgoing instrument .vas acknowledged before me
The forgoing instrument was acknotviedged before me
this ^u' day of ks t 20 IF big 1
1
this 13 day of _Q�e�u s � 20 IS' by
L i,( t" i� I ! tYt fYtC%Yl S I
t "LL (till '3 SLY 51'1 t►1G �1 S
(Name of person ackr.m.,ledging j
(Name of person acknowledging )
(Signature of Notary Public- State of Figr}da } j
(Signature of Notary Public- Stat of Flo
}
Personally Known ' OR Produced Identification
Personally Knoyvn OR Produced Identification
Type of Identification Produced
Type of Identification Produced i
Commission No_ In G7 0 5,y � 7� a 4� yp CHRISTINE
emission No. C-1 L -1 r 1 �° z�
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MY COMMISSION# GG
wr c EXPIRES: Apd 4,
052546 * t
2021 gY p4
9
or' reO aonaea t?w Budget N&Mry
Re�.-isec�G7r1�1?G14
Swvwzs -CHR ISH .
* * MY COMMISSION # GG M2U6
EXPIRES: April 4, 2021
REVIEWS
FRONT ZONING SUPERVISOR PLANS VEGETATION
Bdg�t"lySMce—
i SEA TURTLE
MANGROVEI
COUNTER REVIEW REVIEWREVIEW r REVIEW
REVIEW
REVIEW �
DATE
COMPLETE
INITIALS •
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