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Building Permit
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: C( �� I %� Permit Number: ' VtO boo l Building Permit Application Planning and Development Services Building and code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-M3 Fax: (772) 462-I578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: 139 q 1 024 r Legal Description: Sy1I gb Property Tax ID #: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: L`► [c2 (i�� Li lC� '. wt s�zi f ( 3 f�� R ua i D 14 'Sew, 10, Pacica§t unit- wi-wL CONSTRUCTION INFORMATION: iti na wor to e 132ilcinieclun ert ispermit-checka appy: Shutters Windows/Doors HVAC Gas Tank❑{Gas Piping _ _ rQr Electric EiPlumbing L_.ISprinklers ElGenerator IJ Roof Total Sq. Ft of Construction: 4 �y� Sqj Ft- of First Floor - E] Cost Cost of Construction: $ O U11. Q� Utilities: I Sewer Septic Building Height: O W N ERAESSEE: CONTRACTOR: Name en + : Name: 1 AddressJ3CIga nal�l Company: a City: #�(f it C E State:' J'JT, Address:5(© Pr �t fi l f ky- City: YU(-b— erc& State: Zip Code: 3�1LOS1 � r PPFax: Phone No. I l DL - 46 5' la 0 Z 4 Zip Code: .3 4q 5 E Fax: 7?� 46 -373`7 E-Mail: Phone No.-M- q0{-41' H Fill in fee simple Title Holder on next page ( if different E-Mail: P it (rl State orCou�nfe: CAAlI$I8t$ from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPP€EMMALC€ S"i UMON LIEN LAW IWORMATION: DESIG MGM_ Nrit Applicable MORTGAGE AMV: _ Not Appiicable Name- Name: Address City, Slate: _ Address: City State: Zip: PPusrae Zip. Pion: I=EE SiMPP-EEM € . NotApplicable BONDING COMP Plat Applicable Name: Fume: Address: Address: rag: frhone: Zip: Phtxte OWNER/ OR AFPD `: Applimtion is hereby madeto obtain a permit to do the work and Installation as indicated i certify tthat no work or instaftaaion has mmmenced priosto the issuance of a perrnii Si iancis C 3.m f makes rm rep esentation that �is- Mgr�anting a perallwilf authorize the pesmi£ i;ofatex to build subject stnxtuse vahrch ii in with any apphsabfe loom_ Ow:tErS Assacratttua EaafLS, f}y3dw5 orartrt cov2nanfs that iri3'yt 7e5trlCt ar prohibit SnElt -mayapply- structure_ Please consultmkhyourHomeownersAisoctauorandreviewyourdeedforanyrntrictionsw. in consideration, of the granting of this requested permit, 1 do hereby agree that d win, in all respects, perform the work in accordance with the appraved Plans, life Florida aulding Cordes and St Lucie County Miendanens- The following bi ding permit agfi3ications ace exempt from undergoing a full concurrency reiriemr. room additions, and accessary use to another non-residenbat use accessory structures, swimming puotS MMS, waifs Signs. screen rooms WARNING TO OWNER- Your taatife to Record a Notice of conanumcement may reslidt in your paying'mire for A Notice of Contnfencen-ent must be recorded and meted on the job':fte improver Bents to your propei4,_ before the first inspection. PE you intend to obtain financing consult with ;ender or an attorney before <-nmrr+erar-trio smra r nr rscmdine vour Notice ofCommencement_ The forgoing instrMentvas admowledged before me this nN^ day of g/� 20 74 by MichaeA F Sov lei KamSutbuES PessonayKnown�CR Produced fientificI8or Type of identification Camraiss-M N , 1" ' .. CHAISTINE JOyC[SQtl1}ELL Notary ublic - Stan of Florida t7 Commission Y GG 9847ot iA _�` u„c„mm. EzoiresAW Ii, 20U t to �{fiT ia+ f} Rev. ThLL fbTgWng instrument was adonowledged before me thisl4t- day of - Z. 1 2010 *a Name of pempinaldrig statknent pem< OR Produced kienUfficadort Type of +e + ra + Produced, rj Notary Public - State loaded