HomeMy WebLinkAboutGershakAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _11 i i Cp Permit Number:
Planning and Development Services Budding Permit Application
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578 Commercial Residential 1/
PERMIT APPLICATION FOR:
Address:
Legal Des
Property Tax ID #: 3 0-7
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
(etJ-.�ri'2e-.G, f
(-I
SD
Lot No. t
Block No. 3 %
_Mechanical _ Gas Tank
_ Gas Piping
_ Shutters _ Windows/Doors
— Electric Plumbing
_ Sprinklers
_ Generator _ Roof
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $� Utilities: _Sewer _Septic Building Height:
C3 l� RjI € EIE
ftA7777777777777
Name I, C i C �� �t'"Gyc,k
Name: (4�Ci. i +ana�ca fiC
Address: NV-180 ,W004) fir-
Company:T410r v'k,6,&
City: 'E>C1, 1c
Stater
Address: Is-5-7
Zip Code: ?z e Ste_ Fax:
City: pbc-i--'S¢, ! ,Uc State:
Phone No. 2- .. I
Zip Code: L( _c; Fax: �? (�`1-3 3
E-Mail: 5 �lc (C %� �i f a) bP '1-l�;otr
n
Phone No �� ' _ 3 7-3� L-,172--
Fill in fee simple Title Holder on next page (if different
E-Mail_i (1-Co
from the Owner listed above)
State or County LicenseC
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required
- • _FF' Lauver U� l,ereuy mane to ootaln 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 contlict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of th
in accordance with the approved plansrthe Florida Bu c lding Codes and St. LuetuC �nl, in all respects, ty Amendments. erform the work
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 payi g twice for
improvements to your propert . A Notice of Commencement must be recur d and poste n the jobsite
before the first inspection. If ou intend to obtain financing, consu!ttwth�er or an a rney before
commen ' w or r cur n our Notice of Commencement. Jt/ s /I
re of Owner/ Agent/ Lessee/Contractor
Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S-F" 1,1— COUNTY OF S_. L���
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 'day of r✓.-b4- 20/f by this day of /111r.PJ.['b-c-. 2014 by
/new ro'/v/.,�
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known *�
Type of Identification
Produced
Commission No.
OR Produced Identification
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known ci' OR Produced Identification
Type of Identification
roduced ,...
PC,.,
:e�?fibES:
a ;�a
ROBERTA.BURSON
r COUMISSION # GG 048117
January 31, 2021
B.ndad ihn,1latary Public Underwriters
�o
: E
LOMMission No.
"'F!
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
"IJUERTA. BURSON
mycomm 3OI GG M117
EXPIRES; 31, 2021
Bonded Thru Notary Public Undetwftm
SEATURTLE I MANGROVE
REVIEW ` REVIEW