HomeMy WebLinkAboutLloyd permit appAll APPLICABLE INFO MIDST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
MMMOM
Planning and Developmen t Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax. (772) 462-1578
Permit Number:
Building Permit Application
Commercial Residential -
PERMIT TYPE: �L - v-)4h YY1eol
PROPOSED IMPROVEMENT LOCATION:
Address: M HOV i l la IXi it
Property Tax ID #.
Site Plan Name:
Project Name: L
DETAILED DESCRIPTION OF WORK:
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P-
rider l a4rn�r* 4o
CONSTRUCTION INFORMATION- M' 'rL "C'bacerlr—
64exV
w ;� g -alX-Aft
�, 2 i{1 eb a� lS�Q 1! [014T
AAR1D3 wdrlc�farrr�e rider is�ermit - seck a(f that apply:
Mechanical Gas Tank —Gas Piping Shutters
Electric _ Plumbing —Sprinklers _ Generator
Total Sq. Ft of Construction: t�
Cost of Construction: $ _15AD. -
OWNERJLESSEE:
NameLvti{b
Sq. Ft. of First Floor:
Lot No. Z--J Ui
Block No. _h
egIrL_ L1v41v �+ne
v v...--•.-w� ---_ La1u11
l Ga 1A r7rw[ C
��ON'fe" mcdt & fJbher
Windows/Doors
Roof 5 _— Pitch
Utilities: —Sewer _Septic Building Height:
Address: i M0J
City: Stater
Zip Code. Fax:
Phone No.
E-Ma11:1:—,LAntiA3 Lj c1 r gar
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
!Name: W i�,uct-)
Company:gc)["da
Address: ltb4 3Ee 5. f1') W Cf- A?(CJe.
City: 'PO(+ 3t LUC j State: �L .
Zip Code: 31 Fax:
Phone No I7Z�-
State or County License_ C� I��I��
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City- State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City
Zip: Phone:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFI❑VIT: 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 Home Owners Association rules, bylaws or and covenants that may restrict or proh!bIt such
structure. Please consult with 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 ! will, in al] 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 13E RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
xf aL I 1� J_)� /1"
Signature of Owner/ Lessee/Con ractor as Agent for Owner ature of Contractor/brense Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF COUNTY OF,
The fo_ aging instrumen was acknowledged before me
this f �]"-,day of TXNAM 2()2JDby
1;
Name of person making statem nt.
Personally Known OR Produced Identification
Type of Iden4fication
Produced o Yoj — cl 1A1 a 1 C
YYl
(Signs ure of Notary Public- State of Florida }
Commission Nob 1 4 a C �� L
!.
MY C{IIAIs1IS51oN #
REVIEWS I
COUNTER REVIEW REVIEW
Hw
RECEIVED
DATE
COMPLETED
The fa ng instrument Was acknowledged before me
27-�"ay of R10JU 202Dby
N.r' uan crr n-e'
Name of person making stateme6t.
Personally Known —Ae<OR Produced Identification
Type of Identification
Produced
n
[Sign at re of Notary �Pub€i� state '
CYNTHIAM.NU
ammo ion ol�t�l(i 111. = eCO1NM155iDN#D
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EXi'l3iES: Jarmry2
VEGETATION SEA TURTLE ! MANGROVE
REVIEW REVIEW REVIEW REVIEW