HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICAB E INF MUST B€ COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Numb
i
Building Permit Application
SPlanning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial �caiuciluao
m
I PERMIT APPLICATION FOR: To Select from dropbox, dick arrow at the end of line
Address: D12y .3 ACS,a,
Legal Description: er1
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Property Tax ID #:
Site Plan Name: cc
Project Name: IUD MA—J
Setbacks Front Back: -�r r Right Side: Left Side:
Lot No.
Block No.
INSTALLATION "
00 IL anI
P
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CONSTRUCTION INF�RMATiON� 3 y �' ' �� � # '�`
s�u _
Additional work to be performed underthis permit —check
11HVAC Gas Tank ®Gas Piping
all
that
apply:
Shutters D Windows/Doors
aElectric
Q Plumbing
F]Sprinklers
a
Generator
®
Roof
Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
S . Ft. o First Floor: _
Utilities: L� Sewer0Septic
Building Height:
k - Y .. h. %l. �.: f' ��J"C� i ...t. 'dtL 1 •i _v`. S..A.
�COjVTRAC�"OR
7 �` J."r ',�tFwi "i :.1i1 `' ii, 1iS 4 � r F. fit. k_ t S. ?f:
Name
Name: BARRY MILLS
Address: �Y
Company: CRYSTAL POOLS OF INDIAN RIVER
City: 0'tMy5wState: ��
Address: 4680 US1
Zip Code: Fa--x:
City: VERO BEACH State: FL
Phone No. �LJ
Zip Code: 32967 Fax: 772-770-5961
E-Mail:
Phone No. 772-567 3067
Fill in fee simple Title Holder on next page ( if different
E-Mail: JIMMYR@CRYSTALPOOLSIRC.COM
from the Owner listed above)
State or County License: CPC1457120
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. �!
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ESIGNER/ENGINEER:
_ Not Applicable
"C.. ,
MORTGAGE COMPANY: , Not Applicable
Name:
Name:
Address:
i
Address:
City: "`'
I Stite:l
City: State:
Zip: Phone:
i
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Applicable
BONDING COMPANY: ,Not Applicable
Name:
_Not
Name:
Address:
I (
Address:
City:
I I
city:
Zip: Phone:
Zip: Phone: I
I certify that no work or installation has
St. Lucie County makes no representatic
which is in conflict with any applicable H
structure. Please consult with your Hom
In consideration of the granting of this ri
in accordance with the approved plans,
The following building permit appiicatioi
accessory structures, swimming pools, fi
WARNING TO OWNER: Your failu
improvements to your property. A
before the first Inspection. If you
commencila work or Fecordine v
STATE OF FLORIDA
COUNTY OF ST LL rw
The forgoing instrument ack
this -(0 day of
(Name of perso no edging
Personally
Type of Idi
Commission No.
Revised 07/15/20
)mmence4pri r to the issuance of a permit.
that is granting a permit will authorize the permit holder to build the subject structure
me Owners Aslocration rules, bylaws or and covenants that may restrict or prohibit such
Owners Assoc tion and review your deed for any restrictions which may apply.
guested permit I do hereby agree that I will, in all respects, perform the work
e Florida Build' g Codes and St. Lucie County Amendments.
are exempt from undergoing a full concurrency review: room additions,
ices, walls, signls, screen rooms and accessory uses to another non-residential use
to Record a � atice of Commencement may result in your paying twice for
Notice"of Commencement must be recorded and posted on the jobsite
(tend to obtain financing, consult with lender or an attorney before
S
Agent for Owner Signature of r/I.1cense Holder
STATE OF FLORIDA
COUNTY OF
dged before me The fo - oing instrument was acknowledged before me
2D y{ I this - day of f . 20 �by
ate of F17da I
OR Produced) Identification
iced
M' OMJAMES ROUAN
My COMMISSIONI#GG
EXPIRES: NOVeaww
+_.....? RnndodThmNotaryPu"r-
(Name of personledging )
(Signature ry Pub"OR
of Florida )
Personal Known Produced Identification
Type of Identification Produced
Commission No.
..L`n1y?i'tq!•.," JAMES ROUAN
EXPIRES: November 4, 2020
Bonded Thru Notary Public Underrrribrs
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
ReqEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
,
INITIALS
,