HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: QQ WZO
Permit Number:
1 I J. -
• a
- Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fon Pierce FL 34982 /
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential ✓
MITLICATION FOR: To Select from dropbox, click arrow at the end of line
EPROPOSED
MPROVEMENT LOCATIC}N:
Address:I Y
_fixd0
`
Legal Description: 'Agicl 1 f A L(0 5 Gt4 10 CQ 40
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
b I 'huwl�.(k lav), <<%scer-
ihiC (�c,C&cf RAit W141 10 KW head
CONSTRUCTION INFORMATION:
Itl a wor to Orme un er t is perms -c ec a app y:
(eee(
(( HVAC 0 Gas Tank ❑Gas Piping _ Shutters R Windows/Doors
U
L 1l Electric Plumbing Sprinklers Generator ❑ Roof
Total Sq. Ft of Construction: S�Ft".( of First Floor:
Cost of Construction: $ uUOO ,60 Utilities: t �ISewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Il : Tffi I0(m
Name:
Address j�LIPj [�y� (l!I YS �� e �( q�
Company: iPji}{t�j�VlifllR
City: I c(�'L State: 'L
Address: -(O A T(,(,(ri�ikRz
Zip Code:SL)R5 I Fax:
City: YU(&- I7(C!CPi State: rf,
Phone No. M6"
Zip Code: _ "3 i5! Fax: -7i,2--4&(9--37
E -Mail:
Phone No. -"A- Lda -4(4-1
Fill in fee simple Title Holder on next page ( if different
E-Mail:0.CPS (11
from the Owner listed above)
State or County Licen e: CJy I S 1313 (p
If value of construction is $25OO or more, a RECORDED Notice of Commencement is required.
SLrCS 'MENTAL 4-ONSSTWU UEN IA E€4 Re9 A-ITON:
�Q
Name-
_hiotAppficab#e
fame:
Address:
Address-
Cdy: State:
City: State:
Zip. Phone:
FEE SINIPLE TITLE _ ,_ Not AppiwjW
BONDING CO ANrl: AppCtcable
Name:
_Riot
Name
Address:
Address
City:
City:
Zip: -Phone:
Zip: Phone:
ema i I rnarrnas-rex � .....4_ -
.� ---- �.sz� �vea; wpPUMMn ishereby madeto obtam a pa,-rfitto dothe l-Orkaod insta#Ww as'sndkatetk_
I certify thatma Work or installation has commenced Prior to the issuance of a permit
St Lucie g3 makes no representation
than grantingaperrrritwdilautboszeLhe ratsodriertobuilfthe
wduch -s In with any applicable Home Owners Assoc ationFu�P� subject si nxture
.truucture_ Please consult mhah�r�x�rin?,nvsaw:ra�A.— -,n.i ----wsara�eavenanisthatrna,!restrictor6rohibitsuch
In consideration of the granting of this requested permit I do hereby agree that i miff, in all respects, perform the work
in accordance with the afsproved plans. -the Florida &skiing Codes and St Lucie County Amendments.
The following building permit apliffications are exempt from undergoing afull concurrency rem w room addetiorrs
accessory structures, saim+nlrrg pools fersces, wailssigns, screen rooms and accessory uses to another iron -residential use
M ING To a our{as°usre to Record a Mot'ce rrlay result 1 r,Foar paw i�riee for
iraprcrtrernents toyour
Property- A Notice of Commencement must be recorded and posted on the johsite
before the first inspection. If YOU intend to obtain f nan£iM consult with lender € r an attorney before
STATE Of FLORIDA C I �1 STATE OF EL RMA �I�
COUNW OF COUNWOF
The ing- was ,,.
this r. of M1, 20 24) by
Michftl iv
Person= ORP,
Type of Identification
Produced
The forgoing insulanturas admowiedged before me
this day Of i � 29_10 by
Name of persopinaling stablitient
Personalty KrsownQR Produced identification
Type of Identification
Produced
(SrgnaLureofiva_ stili -State ofriorida} {Si{tatureofNo PubtdcSta�o€Fiosida} I
ComrrEissionN ,.•.:a ''(g'e NWELL
.......... CHRISTINE J r�y4ELL
=�+ F ...;ir of Florida Commsssron d4 Notal Public -State o -((Florida
c Cc ;n n GG X7839
Ex ues •a Commission # GG 017839
'•angio°� Bo edlhrough National olary Assn. 21 2020
eREllllht$ P914N5 ••'Oih`'• on through National otary Assn.
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CUUNTER , iiME REii'iE4i REMEW ftbftW fREVIEW RfVlEW
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