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HomeMy WebLinkAbout1809-0153ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number. • csunaing vermix Appilicavon Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, fort Pierce FL 349182 Phone: (772) 462-2553 Fax: (772) 462-1578 Commercial Residential PhKMi I APPUC;A i ION l -OK: To Select from dropbox, dick arrow at the end of line PHoposLU IMNKOVEMEN I LUCAI ION: Address: 86 1? q FI U r en c e o(z-j _ Legal Description: Property Tax 1D #: �3� �D�D ��� °� - X00 - a- Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Ul=#AILED Ul=5CK1!'lION OF WUKK: L�f*iE �Z'✓ ���L �` l��tCl' CX^ins- J' /0 h' CONSTRUCTIONINFORMATION: . Idition -work to be nertormea unoertnfsperma-ci VAC Gas Tank Das Piping Electric Plumbing ❑Sprinklers Shutters O Windows/Doors Generator FI Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor _ Cost of Construction: $ % �i Utilities: Sewer Septic OiR NERALESSEE: Name Dbiic-LO�Mari C)t-;Q F A1 : on Address �?59 ( Flu rem c e- 0 ti City i� f k si, State: �L Zip Code: _5q069 Fax: Phone No. 71 a� 3 r% ` 4, 9 77 E -Mail: / Rh in fee simple Title Holder on next page ( if different from the Owner listed above) Building Height: Roof pitch CONTRACTOR: Name: C U VET i S ,SA rot i Y% o n S Company: OusTgn1 A,r Llstemg tF-(. Address: I to 15 S E \A I z r ee R Q PO 2'r 7t. L u c t t_- State:Zip Code: 34-g5�2- Fax: 77a?- 6 Phone No. 17 q�L 3 3 S- 3 2 3 2 E -Mail: Cu StS 4:) ao[.C&M State or County License: Ct C O 5[ 8 e If value of mnstnsction is $2500 or more, a RECORD® Notice of COMnw4mllellt is required. SUPPLENiENIALCUNSIRUC IION LIEN LAW INi-URMAIIUN: DES4GNERJENGINEER. _Not Applicable MORTGAGE COMPANY: Not Applicable Name: 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: Zip: Phone: Zi p: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. St- Lucie Countv makes no iepresentat=on 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, bt:laws or and covenants that may restrict or prohibit such 'your structure. Please consult :with your Home Owners Association and reviewdeed 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 with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The folioring building permit it applications are exemptfrom Undergoing a full concurrency review: room additions, accessory structures, swri ping pools, fences, wa`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 Owrier/Lessee; Contractor as Agent for O:vner Sid atureof Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF , COUNTY OF i The forgoing instrumer•.t :vas acknowledged before me I The forgoing instrument was acknowledged before me this rl day of SO 20 1 `6 b1- I this day of rt%AJ:) tt, 20 IV by i In 1'r0i'l , (Name or person acknoe.ledging) (Name of person acknowledging) �jd (Signature of Notary Public- State of R(Signature of Notary Public - State of rIOr1GcT-� i Personally Known OR Produced Identification ( Personalty Kno-wn OR Produced Identification Type of Iden&i©tion Produced i Type of Identification Produced i /: s YP K:r!l l! / f! [Ile YD i Z t �t iti 1 i t1� • �4 CHrt15 st: , . ., Commission No.. t G7 ` ° ,_. :q a '4 CNRISTiNEBENGOHimission No. _1� (! L� c� �` ` t.?�;=? -' •-' •' t t * qt * MYCOMMISSIONIkljGG052S46� EXPIRES: AprO .2021 T'!c ��OITb�� Bonded ThtuBudgettia�iySuvices ---- r••.'ti� tHRgENGLiSFI Revised 07/15V2014 * ` * MYCC)MMiSSi0N#GGMU8 EXPIRES: A014, 2021 i REVIEWS FRONT ZONING SUPERVISOR i PLANS VEGETA T ION l SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS i --- — - --- - —— --- ----' - i - - - - —