HomeMy WebLinkAboutFile0001AII APPLICABLE tNFO MUST BE COMPLETED FOR APPTICATION TO BE ACCEPTED
Date. 1t21t19
Permit Number:
Plonning ond Development Services
Building ond Code Regulation Division
2300 Virginia Avenue, Fort pierce FL 34982
Phone: (772) 4G2-1.553 Fax: (772) 462_1,578
Building permit Apptication
Commercial Residential x
Property Tax tD #: 4425-703-0044-000-s
Site Plan Name:Lot trto.39
Project Name: Clark Residence Block No.
Additional work to be performed under this permit - check a, that appry:
_Mechanical
_ Electric
_ Gas Tank
_ Plumbing
_ Gas Piping
_ Sprinklers
_ Shutters _ Windows/Doors
Total Sq. Ft of Construction:
llrili+;^-.vtilrttg>.
_ Generator _ Roof pitch
Ft. of First Floor:
Cost of Construction'5 bOO.&C,\_ Sewer _ Septic Building Height:
State:
State or Countv License
lf value of construction is SZSOO o.,nore, a ngCOnOe O ruot@lf value of HVAC is $7,500 or more, a RECORDED Notice of commencement is required.
PERM tr rypE: E leCtriCa I
pRoposEp
i N pRoVrM r rur rEcnrrro rv,
Address: 3061 NW Radctiffe Wav
Add outlet for tandscape lights.
OWNER/LESSEE:
Zip Code:
Phone No.
E-Mail;
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTORT
Name:
Company:
Address:
City:
zip code:.?gQ8f rax:
Phone No
S U P P LE M ENTAL Co NSIR U crr o rv TI r Nr rnw I N Fo R MATI o[\I :
DESIGNER/ENGINEER: @
State:
MORTGAGE COMpANy: _ Not Appticabte
Name:
Ad d ress:
City:State:
Zip: ------=- Phone:
BONDING COMPANY:
Name:
_Not Applicable
Address:
City:
FEE SIMPLE TTTLE HOLDER: _ Not Applicable
Name:
Add ress:
oWNER/coNTRAcToRAFF|DVlT:Applicationisherebymadetooo.,,"..pu,-,.o.lo.r.ffi
I certify that no work or installation has commenced prior to the issuance of a permit.
st Lucie Countv makes no representation that is granting a permit will authorize the permit holder to build the subiect structurewhich is in conflict with any a'pplicatjte HoriiJowfiers nss'ocfilion iiiei,"dvtaws or anQ covenantiitrat may.restrict or prohibrt suchstructure Please consult with vour Home owneii Aslofratioi'r;d';.;i6;'i;ij;J;ed i";".ny luri'ri'.,,on, wnrcn may appry
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the workln accordance with the approved plans, the Florida Building codes and it. t-ucie 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
//t'**---
Signature of Contractor/License Holder
STATE OF FLORIDA
couNrY oF 4A-_Lr-rO t Q_
The forgoing instrumqnt was acknowledged before methis'ZL day of *\A-A
zd j3 ov
- itri.n-t Sto=:gzf __Name of person making statement.
/'
Personally Known V OR produced ldentification
Type of ldentification
Produced
Public- State of Florida
Commission No,
Sigriature of Owner/ Lessee/Contractor as 49er,t tor Owner
STATE OF FLORIDAiorritr.it
The forgoing instrument was acknowledged before methtl-Z aay of 5A(\, , zo$ uy
Name of person making statement.
,/Personally Known V OR produced ldentification
ure of Notary
Commission No
oYAifiisAion # cG 68535
Mv Commission Exoires
re61€dly ol,2o2r LAURIE HELLER
o'nr,u.,B'PfllAc 68s3b
My Commission Exprres
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SU PERVISOR
REVIEW
VEG ETAT
REVIEW
MANGROVE
REVIEW
EA TURTLE
REVIEW