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HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number. • nu»caing rermit Appncavon Planning and Development services Building and Code Regulation©ivision 2300 Virginia Avenue,Fort Pierce FL 34962 Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential � PEKMI I APPLIC;A I ION FL)R: To Select from dropbox, dick arrow at the end of line PROPOSED IMPK£3VEMIEN I LUC;AI ION: Address:_ �d000 ,f'. /�r4 ✓`��QQmv� ,�t,� Legal Description: Property Tax ID#: 705 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: L)EIAILFA) DESILKIPIION Ul• WUKK: Glkt ��r �,Ih� ,3�on �yjee� �/�nS� v�� /p/Tr✓ CONSTRUCTION INFORMATION: Val worko e rme under is permit—check a .app Add (l Gas Tank []Gas Piping _Shutters []Windows/Doors Electric D Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft.of First jFloor- Cost of Construction: $ 7 Utilities:7Sewer L_JSeptic Building Height: �OV4 NERAESSEE: CONTRACTOR: Nary e /t'o La d Name: C i;V'7 t S ,S;�rVtVAC n S Address: - Company: Cu s-ro at A % r �u stems City /c:z t ,�'� �ii��r� -- - State:_�� Address: 1 A I i eta-e Zip Code: Fax: ray: fU Rt 9t. ,L act t_ �-�— State: Phone No. YO/ 75-";-ifiD 9. Zip Code: Fax: 7V- .J 3 67- E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: C u S t C,i r� Gc C,l C c.M from the Owner listed above) State or County License: G C' 5 f If value of construction is$2500 or more,a RECORDED Notice of Comnvnce nent is requked. SUPPLEMENIALC:UNSIRUCI[ON LIEN LAW INFURMAIIUN: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: Slate: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: j City: City: Zip: Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit_ St-LUCIe CountVmakes no representation that is granting a pem,it v.,ill authorize the permit holder to build the subject structure which is in conflict with any applicable Dome Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult:vith your Horne Owners Association and rear e^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 with the approved plans,the Florida Building Codes and St-Lucie County Amendments. The folimkiing building permit 20plications are exemptfrom undergoing a full concurrency review:room additions, accessory structures,s%imining pools,fences,.va'ls,signs,screen rooms and accessoR,uses to another non-residential use WARN ING 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 Agentfor Ov.,ner j Sie ature of Contractor/License Holder l STATE OF FLORIDA , I STATE OF FLORIDA COUNTY OF l} '�`. 1 _"!' COUNTY OF t The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me !his .zAI day of Oeloh,en 20 !4' by 1 this �y day of ��roher 20 /Y by • I — i - .-. i (Name of person acknorrledging (Name of person acknowledging) (Signature of Notary Public-Stc�� `•_ 'cn-da j (Signature of Notary Public-State or rloriGB) Personally Known OR Produced Identification I Personally Known OR Produced identification Type of ldentificatien Produced_ Type of Identification Produced + ' Y° CHRISTiNEBENQt l 71 Zr l-imission No-: t c, K .•. � :;_�:. .. . 02S49 Commission No-(-.I6 i C 5K ` E ISSlt7NtSG052546 MY COMM 4� M9 * * c w c pXPiRES:AprI 2021 r0►Tba S naetloTMi Budget rry s. r .' o gel Rex!sed 0/15i3Gl 1 MrcoliMis5loN GG652S 3 ' 'N°3l FIRES:rg a,2o2t i REVIE\A1S FRONT ZONING SUPERVISOR I PLANS ' VEGETATION i SEA TURTLE 7REVIEW OVE i COUNTER REVIEW REVIEW 1 REVIEW REVIEW REVIEW i DATE - COMPLETE INITIALS