HomeMy WebLinkAboutbuilding permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 101 � 1
Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 /
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PEKM1 ! AKPUCA i IU N i-OK: To Select from dropbox, dick arrow at the end of line
PKU#'USEU impKovwEN i LOC;AI ION:
Address: (0 SQ1 ern0� 2—Cad__-
Legal Description:
Property Tax 11) #: ��Jd - (.06_0 Ln L - Lot No.
Ste Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DE l AILEU UESLKiP I ION UH WOKK:
CONSTRUCTION INFORMATION:
:diti al work to be rtormeci under tors permit - cr
HVAC [] Gas Tank []Gas Piping
Electric 0 Plumbing Sprinklers
Totai SG. Ft of Construction:
Cost of Construction: 5
Block No.
LShutters F Windows/Doors
Generator 1 Roof Roof'itch
So. Ft. of First] Floor: _
Utilities: 7 Sewe r F7 Septic
OWNER/LESSEE: ---
NarriE< ao *l O n r mQ r 1� u r-P r. I
Address: ���Q� } %le_
City: V 2ro State: El/
Zip Code: 32q�-I Fax:
Phone No. � _:S' 1 �A (n,
E-Mail:
Rif in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:
Building Height
rtk SAC n
S�ste;�
Compa€�y: L uSiGn1 C� � �
Address: �lYlS �f, 1 dG-.e r-,efa
City, rc R.r _ ucc State:
Zip Code: Fa)c `7`7,?-
Phone No. 3 3 5- 3 l
f E-Mail: C�,j s t C; r s
�s � Goy ctr�
State or County License:
if value of construction is $Z500 or more, a RECORDED Notice of Commencement is requked.
SUPPLEMEN IALCUNS I RUC I[ON LIEN LAW INFURIVIAI [ON.
DESIGNER/ENGINEER: _ Not Applicable
1 MORTGAGE COMPANY: Not Applicable
Name:
_
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: i
City:
City:
Zip: Phone:
Zip: Phone:
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 permitwill authorize the permit holder to build the subject structure
4:hich is in conflict with any applicable home O.vP.ers Association rules, bylati:s or ana covenants that may restrict or prohibit such
structure- Please consult .with your Home Owners Association and revieiv your deed for any restrictions which may apply -
in consideration of the granting of this requested permit, I do hereby agree that I .4ill, in all respects, perform the t.ork
in accordance vAth the approved plans, the Florida Building Codes and St- Lude County Amendments.
Thefolio Ang building permit applications are exemptfrom undergoing a full concurrency review: room additions,
accesson,, structures, siouirnming pools, fences, .va'Is, signs, screen rooms and accessoR, uses to another non-residentiai 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 ; inancing, cansuIt with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature of OvvnerJ�esseeJContractor as Agent for O:vner
(((
Sio ature of ContrarorlLicense Holder
STATE OF FLORIDA ,,
STATE OF FLORIDA .:.
COUNTY OF - _' r'
I
COUNTY OF _
The forgoing instrument .vas acknowledged1 pefore me
The forgoing instrument was acknov; ledged before me
this day Of , �C) (1E .. 20
l
this day of 20 by
C ,
i
s
(Name or person acknovAedging ) (
it
(Name of person acknov ledgmg )
k} s', • ,�..�,'. - -- • r � j '
-��� s /.; i
i
{Signature of Notary Public- State of rcri-la r
(Signature of Notary Public- State of Flori,
i
Personally Knot -Lin OR Produced Identification +Personally
Kno,vn OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No- _ =L4c CHRIS71NEBENt�}Irmission
rCJp C` STAY PUC CHKI ? "' i?
No- l 7 /y J - 4` -
a
* * MYCOMMISSIONS
G(62546
—_ A� " EXPiRE$Aprilt.
t
r = 'n-- BENUUMH
�ort6o aQr"T?n,BLrAotNxMyS"Vkft
Revised0:i15i2014
*: * MyCOMMISSI N9GGM9g
EXPIRES: April4,2MI
REVIEWS
FRONT ZONING SUPERVISOR i PLANS = VEGETA T 1ON
{ SEA TURTLE
I
fvi.ANGR01'E
COUNTER REVIEW REVIEW REVIEW REVIEW
REVIEVL'
FsEVIEW i
DATE
=
COMPLETE
INITIALS
ISH
VMS
321
lft'i s