HomeMy WebLinkAboutFOUNDATION REQUESTPlanning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
SCANNED
St. Luc eY
County
Foundation/Piles only request
Permit No. /l/l -d 3 (oU
I 'WI V"2i1ak 6.a - understand that I am proceeding with
the foundation/piles at my own risk. I understand that there is no
assurance that my permit for the entire structure will be granted and
that I accept full responsibility for any changes that are required in the
foundation/piles design including but not limited to location or design.
Owner �J),S� ff
STATE OF FLORIDA1
COUNTYOF 4 •LUG/�,
The forgoing instrument was acknowledged before me
This`J I day of DV. 20 i 1 by
(Nary j of person acknowledging)
/ n , � Ifs.. �
of Notary Puglic- State
Personally Known V OR Produced Identification
Type of Identification Produce
::�^'°."'�• TAIVIMIE R BEASLEY
Commission No.
�if1�SION # GG071444
'� • EXPIRES March 10, 2021
?drr ,
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECE-I' E
NOV 3 0 2017
PERMITTING
Foundation/Piles only request St. Lucie County, FL
Permit No. 1711-0360
Ronald H Foulks understand that I am proceeding with
the foundation/piles at my own risk. I understand that there is no
assurance that my permit for the entire structure will be granted and
that I accept full responsibility for any changes that are required in the
foundation/piles design including but not limited to location or design.
Contractor
STATE OF FLORIDA
COUNTYOF Indian River
The forgoing instrument was acknowledged before me
This 29 day of November . 2017 by
Ronald H Foulks,
(Name of`pers acknowle Bing)
(/
(Signatur of No V,
Public- State of Florida)
Personally Known X OR Produced Identification
Type of Identification Prod
NANCYCORCORAN
MY COMMISSION#GG145449
4.2021
EXPIRES:
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