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�I INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: -Permit-Number—I q -
RECEIVED
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Building Permit Application JAN 14 2019
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
-2300_VirginiaAvenue,Fort Pierce FL34982--- _
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: ` "�`�'
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PROPOSED IMPROVEMENT LOCATION:.' '"' ' • ucle;County
Address:
Legal De!
Property Tax ID
Site Plan Name
Project Name:_
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UHVAC U Gas Tank UGas Piping U Shutters
❑Electric ❑_Plumbin°gSprinklers. ElGenerator
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Total Sq. Ft of Construction: , J , 1 S . Ft. of First Floor. _
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Cost of Construction: $ 7 o 0 a r Utilities. Sewer 0 Septic
Lot No.
Block No.
Windows/Doors
EIRoof
Building Height:
OWNER/LESSEE.
CONTRACTOR: -
Name
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Name: C. qC
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Addressf :Z,5 V eN VQ Z,
Company: 1 r
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City: i L:l- 101`evKu State:LLc
Zip Code: .3LM-1 Fax:
Phone No����3 I
Address: 4 03 E
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City: Ff rCVc:-e,
zip Code:r3�f
PhoneNo.
State:_EC-
s Fax:
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E-Mail:��-
Fill in fee simple Title Holder on next page I N different
from the Owner listed above)
E-Mail:ce���CGr
State or Coun icense:
U value of construction is $2500 or more, a RECORDED Notice of Commencemem is regmrea.
MORTGAGE COMPANY*.—_ Not Applicable -
DESIGN GINEER: -Not Applkabie-
Name: 17t7 KW a.5 A ✓ l rim
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Address 7k rr er
Address'
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state:
Tip: Phone: - '!
ZIP. Phone:
FEE SIMPLE TITLE MOLDER: - _ Not Applicable
BONDING OOINWAW., Not.Appikable
Name -
Address:
Citir
Phone:
W Phone:
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WARNING TO OWNERo Your faAure to Record a Notice of Camu moanwrt mall result in yotiraaybrgtwIwfor
lmprwemealts to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first Inspection. If you intend to obtaln financing, consult with lender or an attorney before
commencirmor recording your Notice of Commencerneft
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Type of Wanlflratim Produced
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Revised0711512014
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