HomeMy WebLinkAbout1707-0182 building permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPT ID'
Date: I '1 Permit Number: no-V-0-a'
RECEIVED JUL 112017
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 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 <
Address: _ _ %gf'odcl ?i bi-cr o- by- P t erg (?L
Legal Description: ki ' 1 glor ll'_ 3b Mid[con Ri',P� IE6-1,is
Property Tax ID #: 1140, �r�5' 60 72 600 5 Lot No.
Site Plan Name: Block No. 3
Project Name:
J.er, C_
iamonai worK to De
RrHVAC
LJ Electric
errormea
unaer tnis permit- cnecK ail apply:
Gas Tank ❑Gas Piping _ Shutters Windows/Doors
Plumbing OSprinklers 11 Generator E Roof
_
Total Sq. Ft of Construction: 291-7 k4 S . Ft. of First Floor: r L11
Cost of Construction:$ 9f,o5D Utilities:cnSewer ®Septic Building Height:
Name Rv'�-)J w rich'T
Address: II 0[od7 • flMe rneeeflc -Ar
City: (-.1 P -,,rq State: V�(-
Zip Code: 34 R4s Fax:
Phone No. -"7- 3'70 gay3
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: na �tkxL J) q- rru" try tD
Company: 'bi^(7r nu_. to • t�;�s a s 'T+1c�
Ad dress: 0 VoytR So wi Q y, L n-r44'1-
City: State: F4-
Zip Code: `3 IL4 S- Fax: `j 72 L/65; `?873
Phone No. `17-)- Ob) `77gIi1
E-Mail: . f7yA lCfiNSi-iY1L lei GZB� Cor✓�
State or County License: 96 &2110o 3 &?-/
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
i5l/
DESIGNER/ENGINEER: ' _ Not Applicable
Name: W),,Kt 5 ctL �s�rcl.t•{e�lo��c-,����
Address:_23o&> ave
City: Er Mrca- State:IFL_
Zip: '� LFgSo Phone: —77L 60 " T. 1
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of 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 Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender.or an attorney before
commencing work or recording your Notice of Commencement.
Signature of Owner/ Agent/ Lessee
STATE OF FLORIDA
COUNTY OF S�r . L %)c %t
The forgoing instrument was acknowledge before me
this day oflJ 1I , 20 i1 _ by
of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this _\_X_ day of 2011 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu c- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced 1q- L 6t—
Commission No. ���EGNENS
oayn �D g •� MY COMMA�C mbefG022023
6 2020
a dihni NotatY
;; Bon e
Revised 07/15/2014 i ° �_--—�..+�'
(Signature of Notary P lic- State of Florida )
Personally. Known -"°-`--
Type of Identificatio
EXPIRES: December 16, 2020
Commission.No. ; , ` ondodThruNo(fpoat)cunderwdters
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