HomeMy WebLinkAboutBuilding PermitALL APPLI LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -7 2219 Permit Number:
Building Permit Application
Planning and Development Services o
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I�) 11PROPOSFD IMPROVFMFNIT 1 OCATION
Address: bl 1 i
30tkft
OrOCK5th1*1
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Legal Description:
1-7 35
3ci
Is 315
43
ft� 6 7Aa
Property Tax ID#: G5I7' 3t 3' DoZO -OG0-Q Lot No.
Site Plan Name: II Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lik& -(Or Lia' Tw-k[J 9, 5 ionj 1( SEES Lhnox 5?f(t-
ACe sqs+tm w%th -7- 5 K\.✓ heat
CONSTRUCTION INFORMATION:
rk to e e
orme Under
this perm it - check
all
apply-
HVAC
—Gas
Tank
❑Gas Piping
_ Shutters
Windows/Doors
Electric 0 Plumbing
Sprinklers
Generator
Roof
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 3400. 00
Utilities:T]Sewer
Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
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Name:
Address:_ Z-111 S, 3(0 S&\W 1m-
Company:8pyle. � QiF1�(fjgV189/A��
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City: Of+pf�>lff.Q state:w
Zip Code: 34014-5 Fax:
Phone No. T7A a O5 - S$^7 1
r�8(C.
Address:�ld ATU(YI�fG¢
City:State: t5f-
Zip Code: '3 *q `51Fax: 77--- 4&i 373-7
PhoneNo.�a-- °&1-i-i14-1
E-Mail:
Fill in fee simple Title Holder on next page t if different
from the Owner listed above)
E-Mail:I-y)
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_
State or County License: C%rC1$ I813
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Address:
City: State:
Zip: Phone:
cs ► s �., .. -
Zip: Phone:
V WW1:HJ B.UN I HAU0K tii7Vt7: 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 Rome Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Rome 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 fiance 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 fiTnancinR, consult with lender or an attorney before
, ' 4e- 7 �
Signature of Owner/ Lessee/Contractor Agent far caner
Signature of Contractor/License Holder
STATE OF FLORIDA ) , FLORIDASTATE OF a t-tA,`w,
COUNTY Of OUNTY OF_ U�(;� rcJJ�l
The forgoing instrument was acknowledged before me
this J24day Hof,,'' !Z''- d 2DA by
MOW e,
Name of person aking it lenient
Personally Known V OR Produced Identification
Type of Identification
C'JRJSiINE J QQnI 44t
Notary P,,ilc SIat8�olrforida
Commission # GG 017834_
My Comm. Expires Auc 2r 9rnn
REVIEWS
COUNTER I REVIEW
COMPLETED
., Rhi17
The forgoing instrument was acknowledged before me
this- kddayof W(LL _ 26[I_ by
Name of perso�Fnaking statdment
Personally Known yam' OR Produced Identification
Type of identification
CHRISTINE J. CONWELL
Notary Public - State of E OAS9
Commission # GG 017839
My Comm. Expires Aug 21, 2020
PLANS I VEGETATION I SEA TURTLE 1
REVIEW REVIEW REVIEW MREVIEWVE