HomeMy WebLinkAboutSKM_C45820051209390All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I I . Permit Number:
i.. r
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
Building Permit Application
Commercial Residential
PROPOSED IMPROVE MENT LOCATION
Address: -5- �ir�r��7�2A �1 zT -'
Property Tax ID #: Lot,No.
Site Plan Name: Block No.
Project Name: `fir
V1
DETAILED DESCRIPTION OF wO' wig �. ,
f l `l !] r �t r r� r r �1' - z . A, k r � .L\ ; i., •.. , . _
t31�v� A�- c\�4� 1
CONSTRUCTION INFORMATIC}I'J
Additional work to be performed . under this permit -check all that apply:
,_Mechanical_ Gas ark _Gas Piping _Shutters _Windows/Doors
.—Electric V Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Q. L L .Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE;
CONTRACTOR:
Name:2--..541
Name: ZS -AN
Company: `
Address: 14s,z," - 4,0- At'
City: ;V-A---,etx State: j L-
Address: C v
Zip Code: �5 q q,:;7- 7_ Fax:
City
State:-r'—
tate:- '-1Phone
PhoneNo. ��' ,. 7
Zip Code: 344 S—I
Fax:
phone No 77,;7--) 14 '�--
. G_ .0
Fill In fee simple Itle Holder on next page (if different
E -Mall :7F� , kk-ir: r i'
b Ldszr Ako,� C t=
from the Owner listed above)
'State or County License'
IT Value or Construction Is �irbuu or, more, a KMOKOEP Notice of Commencement Is required.
If value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPLMEITALI�TRUi`+ 'l°L4�AIN.
e
.. .........
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY.
Not Appllcable-
—'
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER;
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
ti
LOW n1=K/ L.VIY r KAt, i UK APPIUVI I : Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or Installatign has commenced prior to the issuance of a permit.
St. Lucie Counttyy makes no represe,%t tion that is granting a ermit NI authorize the permit holds to build the subject structure
which is in onfltct with anY pplicab�a Home Owners Association rues, by or and covenants that may restrict or prohibit such
structure. Pease consult w t�i your Home 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
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SPFE BEFORE THE FIRST (INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR. AN ATTORN BEFORE RECOIIpNG XQUR NOTIC OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner S nature
STATE OF FLO DA TATf-G RIDA
COUNTY OF ; AC I� �S COUNTY OF ; TiY 'l
The forgping instrur0eL,nt was acknowledged before me The forgoing Instr Instrument was acknowledged before me
�
thisdayof ►"{cA,_ 20ZP by this dayo 26;Wby
_ -�
Name of person making statemelpt. Name of person making statement.
Personally Known OR Produced Identification Personal) n OR Produced Identification
Type of Identification . tification
of
Of
Commission No. 011 T� (Seat)
REVIEWS FRONT ZONING
COUNTER REVIEW
C.•- .rte,,
f otary Public- State of Florida 1
No. �1 { 8-16 (Seal)
SUPERVISOR PLANS VE.PETATI
REVIEW REVIEW REVIEW
Aly Comm.
51
DANE LYNCH
Notuy Public • Slate of florbda
My Comm. Expires Nov 20. 2020
Bonded ibrouptt Vital Notary Assn.
2013