HomeMy WebLinkAboutbuilding permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
;Nate: S -4 ly
ARM Permit Number:
j -
ouiming rermut'APP"catt+on
Planning and Development se; vices
Building Oral Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 402-1553 Fax: {772; 462-1578 Commercial Residential
PEKMI I APPUC:A i ION FUR: To Select from dropbox, dick arrow at the end of litre
PROPOSED IMPWOVEMEN l LOCAI ION:
Address: 67y5
Legal Description:
Property Tax ID #: -JS-0 -7
Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
UEIAILEL) UESCRIPIION OF WORK:
r
CONSTRUCTION INFORMATION:
a at nor to be rme undet !sperm!t check alt .
1app
AC GasTank as Piping ShLtters � W.ndosl Jaars
Electric Plumbing ESprinklers 12Generator (� Roof Q Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
L/
Cost of Construction: $ 7 Utilities: 7, Sewer ElSeptic Building
Height
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OWNER/ -LESSEE:
' CONTRACTOR:
Name /, #Zt� Name:_ CUf�T(S JFrl<rrtcr1S
Address:_ "OD 16eX (42 `% + Corr. Y� Tr, rK an C c r S
P
City: State: i Address: l (�t 5 f, l i dG �'t ee i t l
i Zip Code: t��fQ�5V7 Fax: may: Pe 27- -9t State:
Phone No. Zip Code: u-52- Fax `77.7 3 5-t ct
E-Mail: Phone No. i 'I z 3 5- 3 --L 3 2
Fill in fee simple Title Holder on next page ( If different f E-Mail:
5 CcOt CCirll
i £
from the Owner listed above} i State or County License:
rf va tue struction is $Zsof conoo or more, a RECORDED Notice of Commencement is recluked. — _ -- — —
SUPPLEMEN IAL CUNS I RUC IION LIEN LAW iNFURMAI K.)N:
Name: ER/ENGINEER: _Not Appli; able ! MORTGAGE COMPANY: — Not Applicable
Name: j Name:
Address: Address:
City: State: i City: State:
Zip: Phone: i Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
� BONDING COMPANY: Not Applicable
Name:
Address:
Address: i
City:
City -
Zip: Phone:
Zip: Phone:
I certify that no vvork or installation has commenced prior to the
St_ Lucie County makes no representat_on that is ;ranting a permit
v:hicli is in conflict with any applicable Home O.-mers Association
structure- Please consult :with your Home Owners Association and
In consideration of the granting of this requested permit, I do hereby
in accordance with the approved plans, the Florida Building Codes
The following building permit appl--catlons are exen-ptfrom undergoing
accessory structures, slou4mming pools, fences, :.la=ls, signs, screen
WARNING TO OWNER: Your failure to Record a Notice of
improvements to your property. A Notice of Commencement
before the first inspection. If you intend to obtain financing,
commencing work or recording your Notice of Commencement.
issuance of a permit
xvili authorize the permit holder to build the subject structure
rules, b:-la,6:,s or ana covenants that may restrict or prohibit such
review your deed for any restrictions which may apply -
agree that I :dill, in all respects, perform, the Cork
and St- Lude County- Amendments.
a full concurency review. room additions,
rooms and accessoR, uses to another non-residential use
Commencement may result in your paying twice for
must be recorded and posted on the }obsite
consult with lender or an attorney before
Signature of Qe�m2r/_essee,'Contrai for as Agent for O•r:ner
STATE OF FLORIDA
COUNTY OF ; '!
The forgoing instrument was acknowledged before me
this is day of _ -);)�by
s
j Sio Signature of Contractor/License Holder i
STATE OF FLORIDA
COUNTY OF
i
� The forgoing instrument was acknowiedged before me
j this day of 'Q b / Y
I
i
(Name of person ackne.+ledging)
(Name of person acknow ledging) i
i
(Signature or Notary Public- State- of Ficn--ia )'
i
Personally Known OR Produced Identification
Type of identification Produced
Commission No-' - YP CHRISTINEBEtt
- 2q3 iFhmission
* SSG
EXPiRESApa
(Signature of Notary Public -State o
Personally Knmvn OR Produced Identification
Type of Identification Produced i
- ,p:.p�4�, Cf!nl$ "" }; iSI
No- 67:?, _ • = r 03
052%6
2021
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