HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONP—
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /� n
Date: SCANNED Permit Number:
BY
L St. Lucie County NOV p4zf (vN11—
OWN
Building Permit Application C'tV
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort PiercefL 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 III
PROPOSED IMPROVEMENT LOCATON:
Address: Se S IL1^�L-S Fi�b�dwEb.,
Legal Description: FIB Seuecz `ao"AE.C,CE P#4,e.l- HOC. Zs2Z-t7(S)
UNIT 8113 NA-xer Z C 0e- 39S i-18I
Property Tax ID #: Z31 I - $a0-00 Z. (o . 0 0 0 - g Lot No.
Site Plan Name: _ _ _ _ Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
17 gar E 0-IL iu 6_xzls � P/'- army Sc,fTS
CONSTRUCTION INFORMATION: .. .
I Iona wor totienerformeci unclert is permit- cneck all apply;
0HVAC Gas Tank ❑Gas Piping fin_ Shutters ❑ Windows/Doors
13 Electric 11 Plumbing []Sprinklers 11 Generator Roof = Roof pitch
Total Sq. R of Construction:
Cost of Construction: $ /9S-°
_ 5 . Ft. of First Floor:
Utilities; Sewer0Septic Building Height:_
OWNER/LESSEE;
CONTRACTOR:
Name CS ( Z LGC
Name: Mark U n
Address: 66J' S
City: FT PiE/LeZ State:,
Zip Code: 344 8 L Fax:
Phone No. 7).7- ( Jq" S�/v Z
E-Mail:
Company: (�i,nl;f %erg;ra
Address: IIYG=+ C-A5_4 SM�=-F
City: Fb, • 1V l=e P State:E
Zip Code:.34/ R R0 Fax:
PhoneNo.77a-060 -'19o_7
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
E-Mail: Ciro . o G 6j -, @m2:,1. crm
State or County License: aLo Re,
If value of construction Is $25D0 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: —Not Applicable
Name•.
Address:
City:
Zip: Phone:
INFORMATION:
MORTGAGE COMPANY: Not Applicable
Name:
Address: City: State:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Name:
Address:
City:
Zip; Phone:
I ertify that no work or installation has commenced prior to the Issuance of a permit.
no
the
build the subject %ucture
is which may apply. ibit such
SUU6Lu1C. ncaac wvn........... I--' ..__-
of this
uested
I do
n all
Iin consideration of the n accordance with the approved plans, the Florida au ding Codes and agree. Lu ie County AmendmentsPerformthe 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-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your pro wly. A Notice of Commencement must be recorded and posted on the Jobsite
he#nea tha first Insnectlo �fri" f you intend to obtain financing, consult with lender or an atto" before
STATE OF FLORIDA
COUNTY OF � 4 rr C /6
The forgoing instrument was acknowledged before me
this L day of Nov 20 aby
t,66C4 E Lr e /-/IC/<S
(Name of person acknowledging )
(Signature of Nota to of Florida)
Known OR Produced Identification
Type of
Commission No.-•`�°NyCOMAM0GG069047
:a = EXPIRES: February 2. 2021
Revised
STATE OF FLORIDA `�cr
COUNTY OF S
The forgoing instrument was acknowledged before me
this 1 day of N ° 20 _j E by
G)tLE 4te- :S
(Name of person acknowledgin )
(Signature of Notary Public- State of Florida)
Known /OR Produced Identification
Type of
Commission
REVIEWS
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REVIEW
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DATEI
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COMPLETE
INITIALS