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HomeMy WebLinkAboutCCF05082019_00000ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: _- S"�'� Permit Number: DuIliaing term" Kpp1lcal-no 1 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34382 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential FEKMI 1 APPLJC:A I ION FL)K: To Select from dropbox, click arrow at the end of fine j 1'ROPOSEL) IMPKOVF-MEN 1 LOCAI ION: Address: Legal Description,: Property Tax ID 0663 -000- q Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: L)E I AILEIJ L)tSC KiP I ION Ui- 1NUKK: /2�r Llli� 3 •� '` yS{El C�,AA5L &I 1Olt�- L1�� CONSTRUCTION INFORMATION: a� a workto e rme under this permit - check HVAC a appry: 7t Gas T ank ❑Gas Piping _Shutters Windows/Doors Electric U Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: Ft. of First Floor: �^Sq. Cost Construction: 2S�' Utilities: []Sewer[ Building of -]Septic Height { OWNER/LESSEE: CONTRACTOR: i Name Jo_m. IL'a11-111 nk 01N&dCLan.6 Name: CU15ETI ncoAcnS Address: 3605 Crta.ba nnLe Dr j Company: Cur,-rcm S tevKS j City: T6 2-r S' T I-uc 1e- State: r L- i Address: t t'e i1 j Zip Code: X52 Fax: City: tPo 2T 2t • 1_ ,. cL t- State: r�- Phone No. -772-3yq-9235 772-y18.153 Zip Code: u'f45Z- Fac `770?- tCf I E -Mail: Phone No. 2 3 3 5-- 3 2 j Rill in fee simple Title Holder on next page ( if different E -Mail: C u s rt a! r I from the Owner listed above) ! State or County License: n i tf value of construction is $2500 or more, a RECORDED Notice of Commencement is required. — - -- - - CISH 05 g la1 3�rrSG.s SUPPLEMEN IALLUNS I RUC I[ON LIEN LAW INFURMAI ION: DESIGNER/ENGINEER: _ Not Applicable 1 MORTGAGE COMPANY: _ Not Applicable Name: j 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: City: Cit} ! Zip: Phone: Zip: Phone: I certify that no cork 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 v:hich is in conflict with any applicable t some Omer s Association rules, bylaws or ana 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 .vil[, in all respects, perform the v:ork in accordance vAth the approved pians, the Florida Building Cedes and St- Lode County Amendments - The follmkiing building permit applications are examptfrom undergoing a full concurrency review: room additions, accessory structures, sumninning pools, fences, :.galls, signs, screen rooms and accessory uses to another non-residential use WARN ING 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 }obsite before the first inspection. if you intend to obtain financing, consult with lender or an attorney before commencing work or recordingyou r Notice of Commencement. I Signature of Ovi:mer/-essee/ContraCor as l gent for Owner I Signature of ContractorlLicense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF I The forgoing instrunmer•.t :vas acknowledged before me The forgoing instrument was acknov ledged before me this day of M h y 20 It by I this day or ✓Y) A y 20 t 9 by --a 1 i (Name of person ackncvlledging) + (Name of person acknov:ledging) (Signature of Notary Pudic- State of F c:r ria) (Signature of Notary Public -State ofl - lonaa= i Personally Known =' OR Produced Identification Personally Known OR Produced Identification Type of identifi©tion Produced Type of Identification Produced Commission No_ - Y ° CHRISTINE B EtIt thmission No- i P:'Y rq I(It -- * ; * MYCOMMiSSION S G 052546 N - N EXPfRES d •2021 + �O1►60 ftrfQeC7}eu&x'3Mila7ry5wirm ,! �•••: n Revised 07/15i3014 * _�* MY COMMISSION#GG mw °_� `ate E�iREs: apn7 a, 202t REVIR AJS FRONT ' ZONING 'SUPERVISOR PLANS ` VE6LTA i iON SEA TURTLE MANGROVE COUNTER = REVIE`•R! REVIEW i REVIEW REVIEW REA/ I EW REVIEW I DATE ' COMPLETE INITIALS ---- -- -- I -- —I l CISH 05 g la1 3�rrSG.s