HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABL INF MUSTCOMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:. U
Date:
SEP 2 1 ISCO
• ",a F .. .Orrs
Building Permit Application SCRN1Epe county, L
BY
Planning and Development Services
Building and Code Regulatlan DivlSlon St. Lucle Countv
2300 Virginia Avenue, fort Pierce FL 34982
Phone.,(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Seleot from dropbox, click arrow at the and of line
PROPOSED IMPROVEMENT LOCATION:
Address: `I TJ U P_ f G I C S
Legal Description: JONes Cen�ert Lai 2 33 3 L'oMM¢rctGl Ctdr��
oLr!4 -
kh1 5 J 'like.`
Property Tax ID 0:
Site Plan Name: Bowe-' C��ei Black No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
5��w •ra�M m� e.
TION INFORMATION:
r o orme un er s perm - c ec a ape y:
Vnas ❑DGas Shutters ❑j Windows/Doors
Tank Piping _j
rElectrlc Plumbing QSprinklersGenerator ORoof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ I l7� utilities. Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name c o r
i s
Name:
Address: 4 5 n N� q K t� e
Company:
City: Qot'a Ra}DN State: EL-
ZipCode:33L Fax:_�(-444-4,404
Address:41117) rs-�J
City;
Phone No. %l - Q 9 4 -
Zip Code: _-721%Q, Fax: M2- 770 ^ oA3S1
E-Mail: fYl Tomes p. �oNes(Unlhcll , l) S
Phone No. -7Z�7o
E-Mail:
FIII In fee simple Title Holder on next page ( if different
from the Owner listed above)
state o un :�
If value of tonstruttinn Is $25DD ar more, a RECORDED Notlee of Comme ment Is raqu ra .
Yrn
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESI311. —E1 7WENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:; Name:
Address: ��5� Ott Address: State:
City,. State: Zip phone:
Zip; Phone: -
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
Address:
City:
ZIP: Phone:
BONDING
Name:
Address:
City:
Zip: Phone:
_Not Applicable
I certify that no work or installation has commenced prior to the Issuance of a permit.
St. Lude Count makeshno represSentaation that is granting a rmit % I authorize the ermit hold%[ to build the subject structure
which Is in on Ict wit anvy applicable Home Owners Assoc aimtion rules, bylaws qr apscovenants th t may restrict or pr� ib t such
structure. Please consult With your Home Owners AssoclaOon and review your deed for any restrictions which may app y.
IIn consideration of the n accordance with the apprtoved plans, tof this he Floriduested a Building codes and St. Lucieree tCounty Amendm ntsperform the work
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•residentlal 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
g fi ature of contractoymeense Holder
—signature of Owner/ Lessee/Agent
STATE OF FLO A
STATE OF FLORIDA` v
Lrtr E
COUNTY OF iWFLv�i 'L
COUNTY OF ��
The forg�ig Ins ent HSas acknowledged before me
The feraoio2lnst en was acknow edged b fore me
this jL day of e - ' 20 by
this•l_MayOf � G . , 20i�by
Cz 0
L . . VG_j L .
In QSnC7%J1 m
(Name of ancknowl g
(Name of erson acknoweedgen
rr n In
ISI ature of Notary P b it. State of Florida )
( ature of Notary Public- State of Florida ►
Personally Known _�ZOR Produced identification __
Personally Known OR Produced Identification
Type of identification Produced
Type of identification Produced
Commission No. F 582seal)
Commission No. 'r •. t31 CICCO
� My COMMISSION #FFee9711
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Revised07/15/2014 eooeeanwlmuePoaarycuoaeM,trn
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