HomeMy WebLinkAboutbuilding permit ALL APPLICABL,E/INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7�� Permit Number
aurrrraing rermn Applicavon
Planning and Development Services
Building and Code Regulation Division s
2300 Virginia Avenue,Fort Pierce FL 34982 /fF
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential
PEKMI 1 APPLIC:A I ION FOK: To Select from dropbox, dick arrow at the end of lime
PROPOSED IMNKUVEMEN I LUCAI ION:
Address: eo(, > e er a n-c a rn
Legal Description:
Property Tax ID#: J111 y` 501-- /7AV/_M() Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Dt:IAILEU I}ESC:KIFI ION UI- WQKK:
CONSTRUCTION INFORMATION: _
Add oDa worko e performedunder is permit-check a .app
[HdAC OGasTank []Gas Piping _Shutters []Windows/Doors
11 Electric 11 Plumbing OSprinklers Generator FI Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor
Cost of Construction: $ e f 73 Utilities: Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name l�a,LLC- C- R6ri%0-4— Name: CVVeT( S , -AnkyY\cnS
Address: 3 3 (>1n c�i t'�Ah r� Company: &k 3-ro nit A , r sy s em
Cityr PG tiL St Lu c k t Stater Address: 11015 S 6 \i t 1 r ee n p r'
Zip Code: 345s2. Fax: ' City: Po P-7 S . L i e. State:
Phone r�-
No. Tip Code: 34-q 5) - Fax_ `77d- d 3 5-i 9 lr c
E-Mail: Phone No.
Fitt in fee simple Title Holder on next page(if different E-Mail: u s t �I I-c vn
from the Owner I➢sted above) State or County License: C 0 S( F I C
if value of construction is$25M or more,a RECORDED Notice of is required. -- - —
SUPPLEMEN IALCUNS I RUC IIUN LiEN LAW INF-URMAI IUN:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: — Not Applicable
Name: j Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable ' BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City: I
Zip: Phone: Zip: Phone:
i certify that no Mork or installation ias commenced prior to tl,e issuance of a permit.
St_Lucie Countvmakes no representation that is granting a permit E ill authorize the permit holder to build the subject structure
v:hich is in conflict with any applicable}some Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure_Please consult with your Horne Owners Associction and revie.j;your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,1 do hereby agree that 1 grill,in all respects,perform the work
in accordance e.,ith the approved plans,the Florida Building Codes and St_Lude County Amendments.
The follimkiing building permit applications are exemptfrom undergoing a full concurency review_room additions,
accessory structures,swimming pools,fences,.tea`--!s,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 reco,ding your Notice of Commencement.
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Signature of Owner/_essee/Contractor as Agent for Ov.rner j Sio ature of Contract or?License Holder
STATE OF FLORIDA STATE OF FLORIDA r+r
COUNTY OF COUNTY OF L
i
The forgoing instrument was acknowledged before me j The forgoing instrument was acknowledged before n,e
this y day of ZO 1,'by I this day of�W ZO 60' by
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(Name of person ackrim.ledging) I (Name of person acknov.ledging)
(Signature of Notary Public-State of Horfda) ( (Signature of Notary Public-State of Floria�y
v =
Personally Known v OR Produced identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
CHRISTINE B EN `1 [ <}RY V(ro4c CYkI�?u• .;'i 151 t
Commission No. - q Yaxtg 0.> H�mission No.vt VMS
-- - MY COMMISSION jlGG D52546 )29
m c EXPIRES:Apra 4.2021
P11:_ c.,. gEHGItSH 3MvFGa
for Asa 2axe0 Th.BuCge tNs7ryS.rwes r "• * MY COMMISSION-GG052546
Re-dsed D;/1-:V3G14 *FL
: \o� EXPIRES:Apr�4,202i
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REVIEWS FRONT ZONING SUPERVISORj PLANS
: VEGETATION SEA TURTLE FOANGROV.E
COUNTER REVIEW REVIEW I REVIEW I REVIEW REVIEW REVIEW
DATE
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INITIALS