HomeMy WebLinkAboutbuilding permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /rag^� I PermitNumber:
ouliming rermt Hppucavon
Mooning and Development Services
Building and Code Regulation. Division
2300 Virginia Avenue, Fort Pierce F! 34982
Phone: (772) 462-1553 Fax: (772) 462-=578 Commercial Residential
PEKMI I APPLICA I IUN FUR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENI LUCAIIUN:
Address: 7 GtyV L-O rld CUP W 6LY
Legal Description::
Property Tax ID tr: a3a / J Dni 00`i - U00 _(0 Lot No.
Sate Plan Name: Block No.
Project Name:
Setbacks Front Back. Right Side: Left Side:
UEIAILEU UESCKIPIIUN OF WORK:
Llke l
L,f
CONSTRUCTION INFORMATION:
Additi- al-tivoTc fo-oe oerfo�med under fhis permit=-cfieck aTT- a eppTy:
G H �GasTank -]Gas Shutters 0window5/Doors
Electric UPlumbing OSprinklers Generator _1Roof Rcofpitch
Tota Sq. Ft of Construction,: — Sq. Ft. of First Floor:
Cost of Construction: $ ✓ Utilities: [I Sewer Septic Building Height:
I OWNER/LESSEE: CONTRACTOR:
Name la-0 c :SvSC� ��enaon i Name: t✓ L' � T I
o ii (Lk G rl i
' Address: 16 f--DU r04f%e_.5 i Company: C u f>-ro nl A S u em,,, j n% G
City: z-ai-chLv O rEf) 1-1-e r l::5 State. Address: 1(t l $ �A I) etc, -e �r ee n.
p�30 Zip Code:�''cec lG'rto Fax: ` F' City: 2T 9t C. uci c_ State:
Phone No. '7,%1- 1973- 05/' Zip Code: `E l52 - Fax '77,? 3�-1
E-Mail: Phone No. ` I a 33 S- 3 2
Fill in fee simple Title Holder on next page { if different E-Mail: C u a t & I r Sys P Cc o [ - C (1 Vi
from the Owner listed above) State or County License: C C-' J ( F 10
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUFPLEMEN IAL CONS I RUC IION LIEN LAW iNEURIVIAl ION.
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
—
Name:
Address:
( address:
City: State:
, CiSmote:
Zip: Phone:
Zip: Phone:
I
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name: I
Address:
Address:
City:
City:
Zip: Phone:
lip: 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 permit it! authorize the permit holder to build the subject structure
S:hiclt is in conflict with any applicable Home O,.Pners Association rules, bylaws orand covenants that may restrict or prohibit such
structure. Please consult :<iith your Hones 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 v.xrk
in accordance i!Ath the approved plans, the Florida Building Codes and St. Lude County Amendments.
The following building permit applications are exemptfrom undergoing a full concurency review: room additions,
accessory structures, stL4mming pools, fences, tea 'Is, signs, screen rooms and accessoR, uses to another non-residential use
WARN iNG 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 wraith lender or an attorney before
commencing work or recording your Notice or Commencement.
Signature of Ov ner/_esseej Cuntrot Lor as Auentfor O;tner
Signature of ContrarorJLicense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ,j ; , " =' ,
I
COUNTY OF --- —
The for oin8 instrument �.- as acknot. ledged befare me I
The forgoing instrument was acknowledg l
B B pzd before me
this day of _j VT_, 20 Abt j
. 1
i
this day of , 20 by
(Name of Gerson acknm�Aedging j
(Name of person, aclmot:�t2dgino )
i
(Signature of Notary Public- Star .., _ _ rile j '
(Signature of Notary Public- State of inn .,. i
Personally Known OR Produced identification �
Personally Knotvn OR Produced ldentific2fon
Type of Identiiccation Produced
Type of Identification Produced
Commission No -: -- - - iq CHR15TtNEBENC
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