HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �"S�/� Permit Number:
J.1 _
ouiming rermit Appilicatllon
Panning 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 '
FERMI I APPLIC;A I ION FOR: To Select from dropbox, click arrow at the end of line
PftOPOSEU iMPKUVEMENI LOCAIION:
Address: 'S�oZG`0 /A1 7,4 *</J//
Legal Description,:
Property Tax ID##: u1 ill✓ f,�� '!. Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
llE i AILEU UESCRIP I ION OF WORK:
QI<< �--
LCONSTRUCTION INFORMATION:
AddWi- naT-woro to-&e er ormed un3er t-Fiis permit-cFiec-k aI aPP y -—i--� -- -
WHVAC Gas Tank []Gas Piping Shutters Q Windows/Doors
OElectric Plumbing Sprinklers F Generator F Roof Roof pitch
Tota Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3/o/9 - Utilities: 11 Sewer 0Septic Building Height
I OWNERAESSEE: CONTRACTOR:
I Name Name:_ CUi"T oAC0S ---
Address: 1100 Company: Lo Tr M A c- i-, S t e;,K; t►u�-
City: da- State: 6// Address: )4?15
Zip Code: �151&0J Fax: City: CO P-T St. L uci e State.
Phone No. Sid- V.2- ,Z606 Zip Code: aIfg5.z- Fax 77J- J 35-1 ci
E-Mail: Phone No. 111 1 3 3 5- 3 2 3 2
Fill in fee simple Title Holder on next page{ if different E-Mail:-_ C u 5 t A I r a o
from the Owner listed above) State or County License:
if value of construction is $2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEM EN I AL C;UNS I RUC i ION '-LIEN LAW I NFURMA I IUN:
DESIGNER/ENGINEER: _Not Applicable + MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: i City: State:
Zip: Phone: i Zip: Phone:
i
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
— I
Name: Name: j
Address: Address:
i
City: City:
Zip: Phone: Zip: Phone:
I certify that no.pork or installation has commenced prior to the issuance of a permit-
SL Lucie Countymakes no representation that is granting a permit vvill authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Assocration rules,by laws or and covenants that may restrict or prohibit such
structure.Please consult with your Home O-o ners Association and revie.-z your deed for any restrictions which may apply-
in consideration or the granting or this requested permit,I do hereby agree that 1 will,in all respects,perform the v:ork
in accordance r;ith the approved plans,the t-lorda Building Codes and St-Lude County-Amendments.
The follmkiing building permit applications are exennRtfrom undergoing a full concurrency review:room additions,
accessory structures,stiiamming pool,fences,.valls,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 record ing you r Notice of Commencement.
Signature of Oviner/.esse&Contractor as Agentfor Oe:>>er j Signature of ContracorlLiceme Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF t; '' ! COUNTY OF -
l
The forgoing instrument;vas acknowledged before n i The forgoing instrument was acknowledged before n ne
this�_day of /l d't,e/(, 2+7 dby I this�day of�Y�aA,4 0 20 by
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!Name of person ackrmtledging j (Name of person ackno+:!edging)
(signature of Notary Public-State of rc6 da) I (Signature or Notary Public-State of F for ica
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Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of identification Produced
ISM
Commission No_ I g jp, CHRIST}NEBENR iI}mission No- _ ,'�� F =? 'r ms
? MYCOMMISSIONS 113va 6 s \` -_ 4 Al
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o} EXPiREsApr .2>72t -
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Reused 0 7/15i301 L
"fin_ EXPIRES:Apr?4,2C21
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RE\rIE\+r1S FRONT ZONING ' SUPERVISOR PLANS 1 VEGETA T]ON l SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW l REVIEW REVIEVd REVIEW REVIEW I
DATE I
COMPLETE
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