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HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 64 -,6 -/ 5 Permit Number: • iiUming rermix i4ppicavon Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential PERM I APPLICA I ION FOR: To Select from dropbox, click arrow at the end of line f PROPOSED IMPROVEMEN I LOCAI ION: Address: /.60L Ti1i1ur1ann1 LK Legal Description: Property Tax ID#: d6fDq'�07 tr/ ��©Cn "� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: �111: ILE1111 tSCt21N t ti3�NQ WORK: l Llkt 1'�� G1/tc 3 /ySter c'/r,,njc OUL �/t�✓ CONSTRUCTION INFORMATION: 7U110ZWor o e e rme un eri s peim�t—c ec a app y:I7 Gas Tank Gas Piping LJ_Shutters Windows/Doors 11 Electric I Plumbing ❑Sprinklers L-...!Generator FI Roof Q Roof pitch Totai Sq.Ft of Construction: l Sq.Ft.of First Floor: ,7 Cost of Construction: $ 7 Y 5' Utilities: Sewer oSeptic Building Height: 1 OWNER/LESSEE: ------ -- CONTRACTOR: Name �, 8, -hctjnl d jr ar-n ,5 hno� Name: 6U CTI S t5A11WAC(i5 i Corn an �uS'TorK A � r ��, S �e�KS �n ! Address: i�..Cs 5 ,ngSu�nn v� P Y�_ i City: For•} ��,p��. State: FL Address: dG .e,�� Zip Code: Fax: City: Po R-T -_9t• L uct t—' State: ��-- Phone No. u•7d ze i �-3 73 Zip Code: 3 l52- Fax E-Mail: Phone No. T1 1 3 3 S Fill in fee simple Title Holder on next page(if different E-Mail: C u S t a I f- 5 5 Cc o f from the Owner listed above) State or County License: if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMEN IALCONS I RUCHON LIEN LAW iNFURMA1ION: DESIGNER/ENGINEER: _Not Applicable I MORTGAGE COMPANY* _Not Applicable Name: Name; Address: Address: City: State: , City: State: Zip: Phone: ! Zip: Phone: I FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: i City: City. Zip: Phone: TjP: Phone: I certify that no trlork or installation has commenced prior to the issuance of a permit_ St.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:,firth your Home Owners Association and review your deed for any restrictions vihich 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 vAth the approved plans,the Florida Building Codes and St.Lucie County Amendments. The follo:L+ing building permit applicatons are exeniptfrom undergoing a full concurrency reviox: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 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/Lessee;Contractor as Agent for amner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA r ; COUNTY OF _ - - COUNTY OF = Tlie forgoing inst;umert,vas acknowledged before me The forgoing instrument vas acknoi iedged before me this_ , day of / v 20 1`%by this 6• day of r—e b ,20 I`1 by ! t (Name of person acknowledging j � (Name of Person acknowledging) f (Signature of Notary Public-State o r=cr;d (Signature of Notary Public State o =icric Personally Knowin OR Produced Identification Personally Known OR Produced identification Type of Identifcation Produced Type of identification Produced Commission No. - y� �e mission No_ _ _ E __y:- .:••_t MYCOMMISSION#PGOSM ' �� ! hi o} � EXPIf�Apra! .Z021 •-- _- - _ - - - tu.tcs orn� am�aTtwtr, rro�sa�ors r .- Im Revised 07115i3014 * * MY #GGOS" 1 REVIEWS FRONT ZONING SUPERVISOR i PLANS ` VEGETA T tON SEA TURTLE idiANGROVE � COUNTER REVIEW i REVIEW REVIEW REVIEW REVIEW REVIEW DATE CONiPLE T E t