HomeMy WebLinkAboutBuilding PermitY-0 A'J-5 4 1�nlj s' zm
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
COL! NT Y �ti
Permit Number:
owilaing rermn: Appilcattvn
Punning and Development Services
Building and Code Regulation [Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 4062-1553 Fax: (772) 402-1578
Commercial Residential
F'EKMI t Af'1'LICA i lU(V HL)K: To Select from dropbox,click arrow at the end of litre
I ROPUSED 1MPK_£0VF_MF_N I LUCAi ION:
Address: 8585 C�allbe�r�_..C,
Legal Description,:
Property Tax ID #: c3yo�rj 703 - Do % / 000 - W Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
UE l AILED UESCKiP I ION 01- WORK:
i
L/ham Jko( C')AnSe OVT /o
CONSTRUCTION INFORMATION:
ACICImonalWOrKtOlDeDertormed under tis oerm!t - check all that am) :
V_J HVAC l,j Gas Tank L_JGas Piping
Electric o Plumbing Sprinklers
Block No.
LShutters Windows/Doors
117 Generator . [� Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First
j Floor: _
Cost of Construction: $ -/�0
Utilities: 7Seweri _ISeptic
OWNER/LESSEE:
Na rii a ''yCe $ �JGL Fr C cc. 44'Eky r-
Adrlress: 11 bz r [D,
City: ort 5f L )CI,e State:
Zip Code: Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:
Building Height
Company: C t S 7G iv % , ru s .' e;'i' l fL CJ.
Address: i �-, 15 -S E Vii, l i dG - r- ee rZ Q /
City: F707T St. Lucite State: r__
Zip Code: z1+175:2. - Fax: `77x7- 3 -t !� c
Phone No. ` i 'l �_ 3 3 S- 3.^L 3 2
E -Mail: C4 s t af- sus Cc
State or County License: � C S i S� j
tf value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMEN IAL CONS I KUC I ION LIEN LAW I NFURMA I ION:
DESIGNERIENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name: f
Address: Address:
City: State: t City: State:
Zip: Phone: i Zip: Phone: ?
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address: t
city: City:
Zip: Phone: zip: Phone: i
I certify that no work or installation has commenced prior to the issuance of a permit
SL 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 applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult 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 vith the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The follmning building permit applications are eaemptfrom undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,sign--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 Ovmer/.essee/Contractor as Agentfer Owner Signature of Contractor/License Holder
i
t
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF j
i
The fo oing instrument ryas acknovaledged efore me The forgoing instrument was acknowledged before me
this�day of ��prr I , 203c this day of ,20 9 by
(Name of person acknowrledging) (Name of person acknowledging)
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i
(Signature of Notary Public-State of F crida) (Signature of Notary Public-State of:lorina
t
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No-',_. CeRISTM5 El RJRhmission No. '~ k^�:`?• 'r 45"
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Revised 0-1/15/2014 ' * MT #GGM=
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REVIEWS FRONT ZONING SUPERVISOR j PLANS r VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE i f
COMPLETE
INITIALS _�