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Home My WebLink AboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: gIL4 120 Permit Number: ® Building Permit Application / Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fart Pierce Ft 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: it (_- aw{�z 3Lt51 Legal Description: �r {/I(�-f1(I(iSa+ - �Ik ��Q�i l� LOT'II1XDfl)IAYA Property Tax ID #: JDI �Li ' D ti 4 -000- JgLot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: i A tll,� sign 60'1-t1� 's K") ham' CONSTRUCTION INFORMATION: iti na or to e ertormed un ert ispermit-c ec a appy: ❑Gas Piping Q Windows/Doors HVAC Gas Tank —Shutters Electric Plumbing QSprinklers FiGenerator E]Roof Total Sq. Ft of Construction:/ Sq. Ft. of First Floor: 0Sewer ElSeptic Cost of Construction: S 3f000. (]t7 Utilities: Building Height: OWNERAESSEE: CONTRACTOR: Name 0 Name: Address © Company: phi City: Jk �rQlr(�. State:_ Address:5IQ Pr ICU iCJ� City: YU(._ RM& State: f=L Zip Code: -;L fti Fax: Phone No. Zip Code: S 41 sa Fax: -77� 4140 -373-7 E-Mail: g �It'SO� Phone No. -"A- `--t- 111 Fill in fee simple Title Holder on next page ( if different E-MaiL•bo_\�(,iMo. 0-n rn State or County Licen e: C A-C I8I S ($ (? from the Owner listed above) if value of construction is $2500 or more, a RECORDED Notice of commencement is required. j t 9 _ tc al I, Fit I ! 1- _XotAWIkable Rx ft Zip --Phone i.Phone: Name: ame. Address: i.-' 111 .III- Phone: f Phone: k ` •:t r r. -•i: -a t t t. - ti r t• In consideration of thegiartaingof 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 Cndrs and St. Lucie Cour ay Amendments. The follow arg bu'ldirsg permit applications are exempt from undergoing full mn=rency review. room additions, accessory stractmes swimming goals: fences, waffst sWnr screen rooms and accessory uses to arrow non-resfdentlai use WARNING TO OWNER: R: Ymwla tre to Record a Nam of Cormuencament mv restdt in yow paywetwice for improvements to your prope€iy_ A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, €onstlit wirdi lender or an attorney before con2mencing work or recordirm Stour Notice of Carrrrrrencernen% Segrracure oF(h>mer{ tssseej[oniracm€' gent for S%rature of Corttractar%License Holder STATE OFFLORIDA COUNTYOF I- l('i STATE OF FLORIDA 1' COUNTY0F — UAuQi The?q�o�rtnstrumentwrasaclvwwledg dbe'oreme The ntwrasacrowtledgedbeforeme thisN'n` day o€_AU,5i- 2020 Cry `ry( fhss=of t- 2026 by Midwoy Name of person/naftstitement, Name of persa ><ai accent Personally Known OR Produced lrientifficatton Personally Ktrtaxrn 1�- OR Produced identifscaUsna Type of Idendfication Type of identification P/rododucd�� Produced � (SignatureofN (Swisr ireofNo#ary lic-Sfaaeofamwa) CNRISTINE JOYCE CONWELL Comms_Son No_ '' • �? Notary Public •(6dillf Florida Commission No. ; t"y".r'r'•°., CHRISTIIJE JO'�WELL Commission R GG 984701 ,g ry Public • too Florlda M1 My Comm. Expires Aug i'r, 2024 •Bonded Commission p GG 9H4101 •orn. through National Notary Assn. _ My Comm. Expires Aug 21, 2024 REVIEWS FRONT ZON NIS SUPERVISOR PLANS MANGROVE SEA fTURT.,E COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE REC€ VED DATE COMPLETED Rev.8f2,i7