HomeMy WebLinkAboutGarrett 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number-
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Yrrginia Avenue, Fort Pierce FL 34982
Phone: (772) 4162-1553 Fax_ (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: S�L
PROPOSED INPROVEMENT LOCATIQN:
Address: 1 L -k 1 6tsvlp-, SIC e,a
Legal Description: i L GLS
Pr0Perty Tax ND *- \3 D 6-- l 11 - 4n=j -Opp Lot No -
Site Plan Name: Block No.
Project Name_
Setbacks Front Rack Right Sade: Leff Side:
DETAILED DESCRIPTION OF WORK: _
-
O✓� S 1
CONSTRUCnON INFORMATION:
AddiflkwxaO work to be perlonned under this permd-dwerk all. that appill-
-Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_ Electric _ Plum,,,bii,,,ng Sprinlders _ Generator :K_ Roof 31 � (Z tch
Total Sq.. Ft of Construction- eIt,�p-_ Sq_ FL of First Fl)or_
1
Cost of Construction: $ 6140 D Utilities: -Sewer _Septic Building Height: Q
OWNER/LESSEE: CONTRACTOR:
Name N (` kp- Name-
V Address: iU\0? C1syL (5A A Company: � i
City: TO l" f" R arcoy, State: E�— Address:
-
Zip Code: 3 � $ Fax: �� q �: State: y1-" .
Phone No. ?7Ti" 6 S' - , q Zp Code. -2thg!2 Z- Farc7%�
� ��
E -Mail: Phone No7Z-`\
-�
Fill in fee simple Title Ifolder on next page I of different E -Mail � rc' \ V.SYJ ® ex r N\ p
fiun the Owner listed ) l State or Coynty License -7-
�
If
If value of construction is 2500 or more, a RECORDED Notice of Commencement its fVquired.
orida
!69
2021
ry ASN.
,4w -w
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: I Name:
Address: P Address:
City- State: City: State:
Zip: Phone rip: Phone:
FEE SIMPLE TITLE HOLDER: of Applicable
BONDING COMPANY: :SNot Applicable
Name:
Name:
Address:
Address:
City:
City
i
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated-
I certify that no work or installation has commenced prior to the issuance of a permit.
st Wumle Cowang nukes no reoresentanon a iat its granting a permit w ll authoniae She permrrirt holier to build the subject structure
which K m conflict with any applcatlie Home Owners Association taylaws
Nils, or and' 07vne arr[5 that may restrict or prohibit
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.such
In consideration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work
in accordance with the approved playas, the Florida Buidiog Codes and SL Lwie County Arawndme nts.
The following building permit applications are exempt from undergoing a full corncumency review room addrtioyts,
accessory stnrlulres, swarnmi lg poolls, fences, walls, sagas, screen roams and amestory uses to another non-resider" 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
commerfdna work or recording r Notice of Commencement.
SignatLYe of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holler
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S't (��
COUNTY OF GLQ .
The fog . in mens was cnowled ed before me The fo in menu was cknowled fore me
this 15 day of 20A7 y this of r zu
, y
\ N_�Nn A'o.-mg- �j AA IIV
(Name of pe acknowledging) (Naammep/errss'�on acknowledging )
I
JLaL,-\L� — Lcg?�o
nature of ffota u uc- ate of Florida ature of Notaryfi - ate of Florida )
Personally Known OR Produced Identification +L Personally Known OR Produced Identification
Type of Idenp�cal ion Type of I -
Produced'•• ., ASHLEY FRECHETTE ./ ;: •µ;: a�,, ASHLEY FRECHET
Notary Public-St of Flaida Notary Public-Stat
Commission No�-��-1(L^i� (n Ci } _ = mis on No. C� •-- CpmmisslonlG 07
Commission/G Ofifdd9 MyC mm. Expnes b
MY Comm. Eapres b8.2021
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REVIEWS FRONT ZONING SUPERVISOR PL ARTS VEGETATION SEA TURTLE AAAINGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED 'I
orida
!69
2021
ry ASN.
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