HomeMy WebLinkAboutBUILDING PERMITALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: LH I —t I Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Address:
Legal Description:
Commercial Residential
Property Tax ID #: ?D ql Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILEDDESCRIPTION OF WORK:
in1 i t t�0 SI B'-. 3. _5 - cii `F fCt�l C- �u - Si mot.
P
STRUCTION INFORMATION:
lonal work to �eeje orme under this permit— c ec dfli
HVAC I _J Gas Tank ❑Gas Piping
Electric 0 Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ `� i 7. 00
app Y-
_ Shutters F—] Windows/Doors
12 Generator 11 Roof Roof pitch
S Ft. of First Floor: _
Utilities: Sewer FISeptic
Building Height:
OWNER/LESSEE:
CONTRAC rOR:
Name_ P-4i`l o r SIli a I t.•i�
Address: &®I , DC
City: State: JF _
Zip Code:34q � Fax:
Phone No.179,--70 8
E-Mail:
Name:
Company: i K;o k A Tirt� �c.�rytyt sr" (LAC
: St'--t,�1 if."ir� j �� r
AddreP6614—
City: 5{- L k State:
Zip Code:3 �f q a Fax:
Phone No.•—17Q,-�J—
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:}{�®o
State or County Licenser
If unL.c of _
-- -- --- -•• •- .......,.�, o ..�........�.. �wLLIU gig Cummencement is required.
_ __
DESIGNER/EiVGINEER: Not Applicable
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iVIORTGAGE®lV1PANlf:
Applicable
Name:
Name;
Address:
_Not
Address:
City:. 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:
Zip: Phone:
wMNICK/ %-Ulm t KAW UK A11-1-11B)VIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work 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 Nome Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Nome 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.
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 inspection. if you intend to obtain financing, consult with lender or an attorney before
commencing wank or recordingrvoiir Nntirp of rnmmannarnan+ r/
�
r
Signature of Owner/ Agent/ Ls& see/Contractor
SigKatu a of contractor icens older
STATE OF FLORIDA
COUNTY OF `�`� �����-
STATE OF FLORIDA
-5 V GL'�.0
COUNTY OF i
The forgoing instr efit was acknowledged before me
this ay of -1 '_0� by
The forgoing instr went as acknowledge before me
this day of, i 20 by
_ ,
(Name of person acknowledging)
(Name of person acknowledging)
VPublic-
(Signature of Notary Public -State of Florida)
(Signature of Notary State of Florida )
Personally Known
Type of ldentificatll MICHAEL GERHA
Produced ;`; WiY C�MMtSSIOhI t3 FF23o848
Personally Know OR Produced Identification
Type of ldentific tiq�`.'_ •..
Produced :-� o M90a$�11eL G�RI°$/Tll��
;' EXP!€tES May 14. 2pi8
:9. 1tSS10Rl ai FF230848
.at, w?•i:• ..1 Ph„KtaN .nec.=,
Commission No.
EXPlf2ES Ma
Commission No. .µr y(�It}t.9
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 4