HomeMy WebLinkAboutBuilding permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'o2D Permit Number
csutioing rermtt Application
Planning and Developrnent Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 3482
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERM I AI'PUCA I ION FOR: To Select from dropbox, dick arrow at the end of line
t;RriP(-1%-U IMPKOVLMLN I LOCAL ION:
Address:
Legal Descr(ption:
Property Tax ID #: J3 // q- 5C / _ / �/4 3150 � 1,
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DI:I AILED DESCRIF I IUM UI- W(JKK:
`J Me 1911, f- P ~! lite—
S"�o�^ /Y.S��'r
CONSTRUCTION_ INFORMATION: .
AMitional wOrKILO 0[]f formedun8erthis permitc
HVAC Gas Tank [JGas Piping
OElectric U Plumbing Sprinklers
ndr6
Lot No.
Block No.
�. �h_ �5� Jr►t� Cha nS�- a� �O/z i _
apps
Shutbers OWindows/DoOrS
Generator L] Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Fnloor. _
Cost of Construction: $
�26S�— Utilities: 0Sewer L�Septic
OWNER/LESSEE:
Name u M Aa-A�
Address: 17r z�14
city.—T'E n S e rN Q eCLC I —State: -f7
Zip Code: 349 5 r] Fax:
Phone No. i 86- 6 5 �C
F -Mail: __ _ _
RH in fee sirnple Title Holder on next page ( if different
from the owner IMed above)
Building Height
CONTRACTOR:
Name: C L' fe -T l S ,SA n c ky\ c n S
Company: �usle, n1 stems i c.
Address: 14� 15 S E 1%r l d G r ee n p
�D R -r ,St . l_ vc(t-- v state:
zip Code: � ;3- 15'2 - Fax: 71TJ J 315-19
lc
Phone No. Z q�L 3 3 S- 313 2
E -Mail: Cu Sttis -P ccol C&M-
State or County License: G D 5[ 8 l
if value of construction is $2500 or more, a RECORDED Notice of Commencement is reftdred.
SUPPLEM EN I AL GUNS I RUL I IUN LIEN LAW I NFORMA I IU N:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City:State:
I City: State:
Zip: Phone:
j Zip: Phone:
1
FEE SiMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address: i
City:
City:
Zip: Phone:
Z`1 p: Phone:
I certify that no work or installation iias commenced prior to the issuance of a permit.
St- Lucie County makes no representation that is granting a permit %viII authorize the permit holder to build the subject stricture
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 Association and revie.v your deed for any restrictions vjhich may apply.
in consideration of the granting or this requested permit, I do hereby agree that I Twill, in all respects, perform the work
in accordance vAth the approved pians, the Florida Building Codes and St. Lucie County Amendments.
The follmkiing building permit applications are exen-.ptfrom undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, Lva'ls, 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/: essee/Contractor as Agent for Qxner �
Signature of Contracfor/License Holder
STATE OF FLORIDA , , I
t
STATE OF FLORIDA
t L
COUNTY OF t} L. �� L C' / E
COUNTY OF t%C-i
The forgoing instrument :vas acknowledged before me I
i
The forgoing instrument was acknowledged before n;e
this ao day of 4 , 20 I � b
l
this AO day of h 20 l 8 _ by
- �i,(� l� lillnc•;� `" I
v
(4u ivrl �r�t�►Frlcn, 5
I
(Name of person ack=c.Jledging �'Name
of Person acknouvied in.o )
(Signature of Notary Public- State of Flq< a
(Signature of Notary Public- Stat of ; lorid�`j
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification Produced__
Type of Identification Produced
! Y v&'I
commission No. (h 67 �' Jac �fi`^ Ba tti CHwsnNEBENt�Fhmission
09 P(/� CNktt?u'r i�
No. Li c
rq
MY C
tGOMMISSION# G05250
mr EXPIRES: AgrJ
'dor
4.1021CHR
r
rbo~ a"ea TTn, e„c9ec No7ry
Rei ised 0;/1_/2014
5.ryices
* * MY COMMISSION GG 052503
�� EXPIRES:A014,2021
\o3,
REVIEWS FRONT ZONING SUPERVISOR
i
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW '
REVIEW REVIEW REVIEW REVIEVy
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DATE
COMPLETE
INITIALS —. —j