HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE, COMPI
ED FORAPAUCATION TO BE ACCEPTED C�
Permit Number:IV
Building Permit Application
APR'�o�
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, FortPierce FL 34982 - "
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: eN dV nl--) �0 N --
Address: 7 1 \ �4 t rl 1_T C --C'\�
Legal Description: S ri c ,l A
L-
Property Tax ID #: I f 1 �. �c7 (� ?C C� r d �) ' Lot No. III
Site Plan Name: 2 Block No. :I
.Project Name. Z n i v f, 1
Setbacks Front Back: Right Side: Left Side:
_Mechanical Gas Tank _ Ga
_ Electric Plumbing _ Sp
Total Sq. Ft of Construction:
Cost of Construction: $ `,_Y O ay
Name
Address: 11 (c
City: ny-- —
Zip Code: -3 q—
Phone No. I
E-Mail: ir►
Fill in fee simple Title
from the Owner listed
piping Shutters Windows/Doors
nklers _ Generator _ Roof Pitch
Sq. Ft: of First Floor:
Utilities: —Sewer _Septic Building Height:
'G. L( CiG h Name: I
_ V 1V1 Company:
l iP ( ( f— State: r4L Address:
—_ Fax: City: State:
J Zip Code: Fax:
C e, n r_ C, d► h.-rod,Phone-No
Ider on next page ( if different E-Mail
bove) State or County License
11 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
JOSEPH E. SMITH,
FILE # 4297035
i
CLERK OF THE CIRCUIT COURT
OR 33001&84
SAINT 'CIE COUNTY
PAGE 59, Recorded 04/11W017 11:39:30 AM
Permit No.
State of Florida
NOTICE OF COMMENCEMENT
Tax Folio No. -3 -H d a — 0 O X - 3
The undersigned hereby gives notice that improvement will be made to Certain real property, and in accordance with Chapter 713, Florida Statutes,
the following Information Is provided in this Notice of Commencement.
Description of
ai �' iY s
Owner information or Lessee for anon $t5e ee contra ad for the improvement:
Name h t' r 0. - C 2 Gt_ V,
Address C i l (rj ( Jae IT . �_ �� �, ;� (.
Interest in property:
Name and address of fee simple titleholder (if different from Owner listed above):
Contractor's Name:
Contractor Address:
" JYfrh:A-
VIM
Surety (if apprxable, a copy of the payment bond Is attached): Amount of bond: $
¢ UAR
Name and address: Phone number.
`"
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Lender Name: Phone Number:
>
Lender's address:
¢ a
x c.a
f-
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by SecC �
o
13
713.1}(a)7., Florida Statutes:
o~c
Name: Phone Number:
coo L
Address:
Lj-LU�Z�
In addition to himself or herself, Owner designates of
CD — r
to receive a copy f}fi� = w
Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes.
: C : CC
Phone number of person or entity designated by owner:
ca co �-- o
Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the
contractor, but will be 1 year from the date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENTARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUSTSE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECfiON. iF YOU INTEND TO OBTAIN FINANONG, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of
my knowlecjge and belief.
(Signature of Owner or Lessee, or Owner's or
(Signatory's Title/Office)
The foregoing instrument was acknowledged before me this a day of 20J
J'h f.-1 i - r) as -0 ) X%eJZ- for dui 14 ti`
By ,Name of on _ Type of autharity (e.g.offfoertrustee) Party on behalf of whom instrument was exec
utFed
(Print, Type,
Name of Notary Public)
Personally known_ ro produced Identifwtlon
Type of Identification produced