HomeMy WebLinkAboutPacheco Permit ApplicationAiIAPPLiCABLE I{UF* IVIt'ST BE COMFTETED FCR APPi.ICATIOru TO EE ACCEPTES
Date:Perrnit Number:
LUEIE
ffi nx $ 8d Er"lg Fenrm st App$ Eeat[on
. F lon n i n q and Dev el opmeni Services
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23AA \/irginia Avenue, Fort Pierce FL i4982
Phone: {777} 462-1553 Fax: l7}2} 462-1575
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Address:
Property Tax lD #:
Site Plan Name:
o OD l-st liJc. l\ { \L ,
Block l!o. 85%dn"*6iv* R.^^
Projecl Name 5tv.
New Eiectrical lVetei- tttl *Second ilertrical tuieter p( &
Additionel work to be performed under this permit - check all that apply:
_Mechanical -* Gas Tank _ Sas Piping _ Shutters _ Windows/Doors
_ flectric _ Plumbing _ Sprinklers _ Generator _ Raaf
Pond
Pitch
ioiai 5q. Ft af Construction:1t"\Sq. Ft. *f First Flo*r:8t
Cost of Construction: $\)Utilities: _ Se,rrrer _ Septic Building Heigh t, \5
lf value of construction ls 2500 or ffiare, a &ECOREED Notice of Comrnencement is required.
if value of F{IIVC is $7,508 or ffiore, a fiECOROED ruotice of Comnrencement is required"
PLR IV IT APFL| CATI CI ili i:C F. :
Phone ruo. 1-)r 33i 9l5V
Fili in fee sin'lpie -i-ltle Flslcler on fiext paCe { if different
frorn ti"le Owner listed above]
City:k ?c..e-
zip code: ?.tQSl
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Stare:EL
Na rne
Address:
Phone No "+1 <" Ott{e (xt aSoS
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state orcounty iicense CBC\?SSR)il _
State:NL
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City
Fax:Zip Code:
Company
i\ame:
bobtor.t
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PROPOSED IM PROVEM ENT LOCATION:
CONTRACTCR:
J' d4lzrt\ut iy'r
Name of person making staternent.tlllltl
Pr-rblic State
Commission No.
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GEO
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5i gnatu re Flolcier
Produced
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Personally Known / O*
Tvpe of ldentifieation
r as Agent
Commission No.
Owner
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5tate
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Ap{i\
l{ame of perscn m
CRPersonaily Knou.rn
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lype of identificaticn
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REVIIVV
SEA TUET1-E
REVIEW
PLAI\5
REVIEW
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RIVIEW
ZOi\ING
RE\u'lIW
SUPERVISOR
REVIEW
REVIEWS FROI!T
CCUF,ITER
DATI
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DATI
CO[IPLTTED
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/tt': Pn0ne:
-{t*rt Applicable
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IM0RTGAGH C*MFALlY:
Ilanre:
Address:
City:
mrSie rurmlENGtltEER: .-. Not Applicable
State:
Phone
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Address
City
Zip:
Applicabie
7in
BCIruDIruG EOMPANY:
i\anie:
AU U I e55:
l',Jot ApplicableFEE SIIUPLE TiTLE FISI.DEB:
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zip:
SWNER/ tpruT'HAgTCIfi AFFIDVIT: Application is her^eby maCe to obtain a permit to eio the r,vork and installatjon as indicated.
i certify that no w,:rk or instailation has commenced prior to the issuance of a p-'r'mit.
qr i r!cie iorrnt'r rnal<e-: no recresenLation lhat ,i Errnting a pcrnr.t wil! authorize the perni: holder to build rhe subiect structLl!'e
,*i,iin ii in confiict ia,iith anv aprrlicable Home Orruriers Asiociarior rules, byrav.rs or ano covenants tl.at may restrlct or pronlolt srrcn
iii-,'i'ijie. ptejie-icjniuti*irtl-iouiqo-c Owner: Associarior and revierv you;' Ceed for any restrictions which may appry.
ln consideration of the granting of this requested permit, i do hereby agree that I wlll. in ail respects, i:erform the woik
in accordance with the ipprovid plans, the FloriCa Building Codes and 5t. Lucie Ccunly Amendments.
The following building permit applications a!'e exempt from undergoing a full concurrencY review: room additions.
accessorV structures, swimming pools, fences, wails, signs, screen roorrs and accessoi"y usesto another non-residential use
\AiAPhII cr t SWNEffi:failure to RErord a Notree of forcmencement mav result tn naying
in the
twice
rnpi"ovements you t-LC of Co mmencerneni lltu)t be (l:corded pubiic rec0rds of
Lucie County enc before the fi rst f vau intend LU ohtai n fi na nci ng,consul t
work or r Notice of Ccmmenceme
or
and subscriSsd before me ci
Oniine Notarization
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SUPPLEMENTAL LAW
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