HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: b \ Permit Number: L. C?0 '""05(.06
'COUNTY" IVSD
,F_:L.O R [ D A - j441
Building Permit Application Permtt; 1019
Planning and Development Services St 4u 9 oe
Building and Code Regulation Division %C 4en Fant
2300 Virginia Avenue,Fort Pierce FL 34982
P,hone: (772)462-1553 :Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSEQ_lMPRQ.vEMENT:LO:CATI:ON ..:-� -.:�.:•: -.. •... :. •.:.::. :..:. : _.: .;.
Address:Liq OCA
Legal Description: Pa II d y F,n t'S
Property Tax ID#: 13( a -go i -OOa•Co'OOO'g Lot No. 3-3
Site Plan Name: I Block No.
Project Name: Ch .S KQT�CQ
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIONOF WORK:
Chc.r1-6e- OLUt' d00 (-CS) (?O S i Z chancy-
"X
hant e-
CONSTRUCTION.INFORMATION: ...- :.•
Additional work to be performed under this permit-check all;b apply:
HVAC _Gas Tank _Gas PipingII Shutters Li
nWindows/Doors
Electric ❑ Plumbing ,Sprinklers I (Generator
ri Roof
Total Sq. Ft of Construction: 5,9t.of First Floor:
Cost of Construction:$ } "T � -L Utilities Sewer _Septic Building Height:
•
OWNERfLESSEE. ;::�.�::::�.._::.�=.:.:_ :::=a-;.. ::�::�;-.>:` :;=-..: 'CONTRACTOR- :'•._ -�';-.:� . . .. .. ... . .. . .
Name7)6 n {'cy r-c 4-(cc I Name: 37-:, `_> iC,-(1 :c—
Address: -11 OC, Ecccte. Inc i J e Company154-(-) :k CL-
City: f d st C 2 State: N l ! Address: it l '-79-al
C r Je
Zip Code:3L1.QS I Fax: City: i , - - !ry 'c-z C' State: }- (---
PhoneNo. 7 -9DGl'ajO4 j ZipCode:35` l a--- Fax: 4t
E-Mail:
Phone No. 5-41-,1- ' G f L'S
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) l State or County License: L (.(? l- C ��chr�S 3'-
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
.. _�.� ice:-: ::..7�6 : ti.::- "
:•.5,��.;�P N..:> NEST .U�Ct!nn'.�I��.L1Et��•�IA1N°�I�FORi1/IATION". - - �:�:
_<,' ;<• 'Wiz='
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: I Address:
City: I 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: I Zip: Phone: •
I certify that no work or installation has commenced prior to the issuance of a permit.
Si. Lucie County makes no representation 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,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review 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 with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
1
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,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 in pe4on. If you intend to obtain financing, consult with lender or an attorney before
commend 3rkgrrecording your ►.•tice of Commencement.
'Ad' t- - ---- \
lg ature•f Owner/Le de/A_ent ature of Contractor/License Holder
STATE OF FLORI I STATE OF FLORI A
COUNTY OF U►ti_. J _71 , COUNTY OF W.A. l✓v— c •PC4 _
The for oing instrume t� was acknowledgecjkefore me The forgoing instr mens was acknowledged efore me
this 7iay of c , 20 ( by this 0Z3day of oiO.K.)O. L)C1.1 �20 19 by
DriJ•61 iicgcc—<Cl c-Z—airyvg_. ..Th '1- 3.,A) k,5
(Na •- - - -cknowledging) (Name of person acknowledging)
• tea �
�
ck
(Signature blit-State of Florida) (Signature Notary P tic-S e of F rids) .
Personally Know k .••"•'PP`QR Produ -• .• 4 ff ljon " Personally Known OR Produced Identification
Type of ldentifica i `'�•,�3'�' _ • .;,,e. L Type of Identification Produced
,,,, 1Ti Commis�.J�n#FF 232857 Commission No. va: f�� tt�
Commission No. 9,:��. 9°,' .•. Comm. pfrel�Aug 31,2019 r =otR,.,�i,�, AN
s MY COMMISSION#FF 951069
„A--u,..,,*...g ,:,,-- .-- .,..--ram- ^40-,,q9..,,,.._. ,-' e",:rT1 - EXPtRC&. 1'2.2C424
Revised 07/15/2014 Topp,.. Bonded Thru Budget Notary Serapes
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER; REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS _