HomeMy WebLinkAboutSullivans permit application-
All APPLICABL
Date:~~ MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
_ Permit Number :
it~--.. -Building Permit Application
Pion · nmg and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 L Phone : (772) 462-1553 Fax : (772) 462-1578 Commercial Residential
PERM IT TYPE: U/ f AIJ)r1w ::>
PROPOSED IMPROVEMENT LOCATION: . '"
'
Address: 55/~ D~t,t ~11,U [)t-
Property Tax ID#: 13 £3.,. >O'L.'OOf.tJI, t'q) ~o Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCR i PTION :0F WORK:~-' J . .
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/ltl'I IK,(w,£1,.)( o.f CzJ SIi j./orJ -:v,tPrcr t,.J{fVQ~.
I CONSTJU)CTION INFORMATION: I·"" I ,, : i ..
Additional work to be performed under this permit -check all that apply:
/4dows/Doors Mechanical -Gas Tank _ Gas Piping -Shutters -. -
Electric _Plumbing _ Sprinklers -Generator Roof Pitch --I
Total Sq. Ft of Construction: t O .s 7-Sq. Ft. of First Floor :
Cost of Construction : $ 7)00 Utilities: -Sewer _Septic Building Height:
OW:N~_~/,tE~S..E'E: ., , .... ·" -~· .. -.', · CONT R'ActOR (r~ -~..,,:,.. ·"" ,.
" ' • .' . \, .i;" • q . , ' 1 •
Name <'5 ATM~ Sy__1 LI i,lft!} Name: k1i-M~ l lv'!I L(l/}?
Addr~s ~: 1"iS1'/,, .. {:ti# /1-Uµ 011-Co1,11pany : £,l/~1'v~orfl ~l--0-•
P'.x. _e_o Ad~·re ss:·P. t'·:· ~o), r2-ZC7 ,1/.
City : State :
Zip Code: Fax : City: State:~
Phone No . Zip Code: .J'fl..7 2 . Fax:
E-Mail : Phone No
Fill in fee simple Title Holder on next page ( if different E-Mail /If #fl/rt l)MJf {?~Ptfl 6µ (6fJ'f1.. ,4l.71'tl<
from the Owner listed above) State or County License
e.,o~-
· /' «r~ 1~1117 n
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required .
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name : Name : Address: Address: City: State: City: State: -Zip: Phone --Phone: Zip :
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name : Address: Address : City: City: 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.
Sth. _Luhc!e _County _ makes no representation that is granting a permit will authorize the permit holder to build the ~ubject sthr!)cture h
w ic 1s m conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or pro 1b1t sue
structure . Please consult with your Home Owners Association and review your deed for any restrict ions which may apply .
~n consideration of the granting of this requested permit , I do hereby agree that I will, in all respects, perform the work
m 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
"WARNINC TO OW ER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYINC
TWICE FOR PROVEMENTS TO YOUR PROPERTY. A NOTICE OF CO ENCEMENT MUST BE RECORDED AND
POSTED THE JOB SITE BEFORE THE FIRSlHl'IISPECTION. F YO END TO OBTAIN FINANONC, CONSULT
WITHY R LENDER RAN ATTO FORE RECORDINC YOU TICE OF COMMENCEMENT."
ATE OF FLORID~L '
COUNTY OF I M t1/
The nf!.R_i ng inst_1,.H~jlt was acknowledged befo re me
this ,/''day of ..:JJMfL. , 20M._ by
Mt'c Aael rw7lo&f7
Name of person makingai;ment.
Personally Known _LOR Produced Identificat ion __
Type of Identification
Produced. ____ 1 _~~a;;a1.;1----.-~
BELINDA DARDEN I . -.
Commission No . ____ _ (Seal)
STATE OF FLORIDA
COUNTY OF __________ _
The f
this
· instr ent wa s acknowledg,:? before me ~....., _____ .20':U-by
Personally Known OR Produced Identificat ion __ _
Type of ldent ificat' n
Producedl ____
Commission No . ____ _ (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW