HomeMy WebLinkAboutCCF06032019_00000ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �6 Permit Number:
•
outjaing retma App icavon
Planning and Development Services
Building and Code Regulation Dvision
2300 Virginia Avenue, Fort pierce FL 34982
Phone: (772) 462-1553 Fax: 772; 462-1578 Commercial
Residential
pRoP }SEI) IMPKOVEMEN I LOCAI ION: --
Address: - — a�5/ �Q /I/2y 22
Legal Description:
Property Tax ID #: aya�- boa -,�, Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
L?E I AILED UESCKllP 110N vi- IAfUKK:
lZc /y L/� /��� �ys�cr' �f Arsc.✓fi �n/tom
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CONSTRUCTION INFORMATION:
o a wom to a oe rme ender t ss permit - c
H;IAC Gas Tank []Gas Piping
ElElectric U Plumbing Sprinklers
Totai Sc. Ft of Construction:
Cost of Construction' 5
y61
OWNER/LESSEE:
Narrie_ 'LLC')l
Add re ss:�
City: �GiLT
all tnat appry:
Sh utte rs
Gene rato r
Sq. Ft. of First] Roor:
LltilitFes: SewerRo+ 15eptic
State: 4�:7c-
Zip Code: 34i5Z Fax:
Phone No. y& 6 -3C 7- 363 42
-Mail:
Rif in fee simple Title Holder on next page (if different
from the Owner listed above)
DwndowsJDoors
.17 Roof Roof pitch
Buiiding H ieight
CONTRACTOR:
Name: CUtiTi S 5A1.k"ACrS,
Company: LU-5-11 0A1 A 5<; 5 t evvi�
! J
Address: (rii5 �-; l{ dG �(r-eerz
W. PL r t e, State: r-L
Zi p Code:
3'f4SZ- FaY_ 212 • 3 c is c
- `
Phone No. �3S - ���
2
E-Mail: s t s s cz o a rr�
State or County License:
if value of construction is $2500 or more, a RECORDED Notice of Commencement is requked.
SUPPLEMEN IALCUNS 1 RUCTION LIEN LAW INFURMAI ION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
j Name:
Address:
' Address:
City: State:
Cit+{: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
i BONDING COMPANY: Not Applicable i
Name:
Name: I
Address:
Address: +
City:
I
City:
Zip: Phone:
zip: Phone:
I certify that no v,rork or installation ilas commenced prior to the issuance of a permit
St- Lucie County rnakes no representation that is grnting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, b>>laws or and covenants that may restrict or prohibit such
structure- Please consult,.-Pth your Home Or.ners Association and revie j 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 folior, ing building permit applications are ewemptfrom undergoing a full concurency review: room additions,
accessory structures, S'Lornming pools, fences, .valls, 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 work or recording your Notice of Commencement.
l
Signaiure of QErnerj_esse2jContrczor as i�gent- per 0..+per !
- 1
Signature of Contraczor, Ltcense Holder
STATE OF FLORIDA
STATE OF FLORIDA <:
COUNTY OF - _ - 1
i
COUNTY OF = =
The forgoing instrument was acknowledged before me j
The forgoing instrument was acknotviedged before n.e
ibis day of 2t7 idby I
j
this day of 0 by
1
;Name of person acknowledging j I
l
(Name of person acknov:ledging ) i
�Public-
(Signature of Notary Public- State of F cr,-ia j f�
(Signature of Notary State of =loriciaj
- /• i
Personally Knowin ='' OR Produced Identification i
Personally Known OR Produced Identification l
Type of Identification Produced I
Type o; identification Produced i
+
Commission No- -. _ 2q aP,'CE CHR1STiNEHENQMthmission
- i. _ n?v Poo, 12 ?
No_ � = ;r' i =`-
* * MYCOMMISSION 3
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FRONT ZONING SUPERVISOR I PLANS ` VEGETATION
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DATE
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