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HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ^2�� (� Permit Number: ouiming rermil Hppiicavon Manning and Development Ser ices Building and Code .Regulation Division 2300 Virginia Avenue. Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PEKMI I APPLIC;A I ION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPKUVEMEN I LUCA I ION: Address: F Q l7 A,_AAIP. LeIZC%7 Legal Description,: Property Tax ID Ii: 2 ya 5 ^ 7,!q5 Do0= Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: DE I AILED DESUKIP I ION OF WORK: �,�, t. � '->, �,lfr P_ 3 s T� /�/SP`'r ��rnx�.- gam' /p�✓ Lot No. Block No. CONiR CTION INFORMATION: Ad3k under this permit - cFiec a appply. -"— - - HVAC []Gas Tank ❑Gas Piping Shutters F—ltiNindows/Doors IJElectric El Piumbing Sprinklers Generator Roof Rcof pitch Totai Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Y37 1�/ Utilities: E]Sewer Septic Building Height: OWNERAESSEE: �} CONTRACTOR: Name 4�/ Address:&�/ %�Gdd1 _ CcGL City: �0�� Q�� CZ� State: 1'4 Zip Code: Fax: Phone No. 7 2 a L-F y, lv.2- 7S E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: GUVCTh1a0\ L J" '.Company: Cus-rom A , r Su s 1 Lems LNG Address: I'�(S S E VA I aa-t !�recn 0 r' City: (02T 9t . C oci z_ State: r'Y- ZipCode: a+g59.- Fax: 77�?- 335-196� Phone No. '7rla. 335-3.232- E-Mail: 0-4 St&Ir Ctis y ctol•CGvm State or County License: � 4 C 5 (810 if value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENIALCONS IRUCTION LIEN LAW INFORMATION: 1Jr-11cu1urrVttvvi1vtttt: -_•_- Not Applicable Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: — Not applicable MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Name: Address: City 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 permitv_ill authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws orand covenants that may restrict or prohibit such structure_ Please consult :•nth your Home Owners Association and revie a your deed for any restrictions 4vhich may apply. in consideration of the granting of this requested permit, I do hereby agree that t .yill, in all respects, perform the erork in accordance with the approved plans, the Florida Building Codes and St_ Lucie County Amendments. The following building permit applications are eaemptfrom 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 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. s i Signature of OE=,:per/Lesseef Contractor as Agent for O:41ner r Signature of Contractor/ License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF _ COUNTY OF The forgoing instrument :=ras acknowledged efor2 me The forgoing instrument was ackno►viedged before me this day of this day of — 20 by (Name of person acknmMedging) (Name of person ackno.s [edging ) (Signature of Notary Public- Stat of F orkla) (Signature of Notary Public- State of , ioriri i Personalty Known OR Produced Identification Personalty Known 0.OR Produced Identification Type of identification Produced Type of identification Produced Commission No-'.;.* _ - 2qs °t CHRMIM8 mission No. * * WCOINSM# 3GOMM * t 1 - Revised 0:i15;i201 f t'iyi0x#C_Go'>gga SPIRES.-AmH4 2t»r REVIEWS FRONT ZONING SUPERVISOR PLANS i/EGiTATiON SE4TURTLE MANGROVE COUNTER REVIEW REViEW REVIEW REVIEW REVIE%A' REVIEW DATE COMPLETE i INMALS - 06MG