HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE CC I--,' 4TED FOR APPLICATION TO BE ACCEPTEu
Date: A.'_)-G-Re7 %4moo awl *Is Permit Number:A(� I a- 012-9
i
09NNVOS RECEIVED
Building Permi ation DEC 13 joils
Planning and Development Services WC PERMITTING
Building and Code Regulation Division BY St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982 ';t. LUde COUVItY
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Sign
Address: /0 7a�'� 5, aS IftU f�
Legal Description:
Property Tax ID #: 3qlC[- 5-o/ - 6-boq - Ale- D Lot No.
Site Plan Name: Block No.
Project Name: apie Shvm�'g
Setbacks Front Back: _ Right Side: Left Side:
Remove existing wall sign and install new sign. Connect to existing electrical.
UUMU11di WU[K LU UMHU1111eU UI]Uel
0 GasTank
OElectric Plumbing
L1115
Pe1111JL-L[1eLK d1i [ndplAy.
as Piping Shutters
[]Generator
E]
Windows/Doors
Roof = Roof pitch
Rsprinklers
0
Total Sq. Ft of Construction:
Cost of Construction: $ � 0
S Ft of First Floor:
"Ll —
utilities Sewer[]Septic
Building Height:
W,
Namezi)CiF 5kokc 610
Name: `1'14qWQ 2jVZA12_
Address: 6V6-1 M,,9121
Company: Ahit),61- &6;�
city: Bztocaff6 State:
Zip Code: Zs1.2_2_ Fax:-
Phone No.—
Address: A614, Ilk," XdA. /V
City: 4ew6:0 State:
Zip Code: 3;5�773 Fax:
Phone No. 919 -,777- 6B--7
E-Mail:
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E-Mail:
State or County License: A'Y-?/3-&J
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
,�SUPPLEMENT-A�L-CON,S-TRU6,�iuN
------------
LIEN LAW'-
7
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
State: —
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: _ Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conrlict 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 d to tain financing, consult with lender or an attorney before
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commencina-wok-orrecenI Piinoavo WWjoc_e'� Commencement.
:;�� - 4L44e�� S
as Agent for Owner Signiature of Contfac�&/License Holder
STATE OF FLORIPA
COUNTY OF t);�. I
The forgoing instrument was acknowledged before me
this a day of 20 Ugby
STATE OF FLO7
COUNTY OF "'�o
The forgoing instrujm2nent was 4cknowledge)Pefore me
this—&dayof 20j��by
1LEVA S&RII�Nz P1cff4,eb 7X�4o,�?_
(Name of person acknowledging ) (Name of person acknowledging)
(Signature of Notary Public- State of Florida (Signature of Notary Public/State of Florida
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced EU S�k L I entification Produced
S NIEL EN
Commission N .......... KAIII FF I EtHm sion No. ......
on tie I BRENIAHAMPION
c orn
ion E pifes
-S my c'mmiss Nolary Public - Siits of Florida
my Co.
,,ne 12. 20
2A
Commission FF 098363
Revised 07/15/2014
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