HomeMy WebLinkAboutpermit app for 102 gotham ct st lucie countyAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
Plclnning and Development Services
Building and code Regulation Division Commerc.lal
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential
PERMIT AppLicATloNFOR: fle -#oo f
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Site Plan Name
ProjectNawhe:
BIock No.
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit-check all that apply:
Mechanical Gas Tank Gas piping Shutters Windows/Doors Pond
Electric Plumbing _ Sprinklers Generator ]£ Roof
Total Sq. Ft of Construction:
Cost of Construction: S
IC8OC,
? 2,Z€ . C) a
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
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Name.TEe{rY R3ec,hull+h Name.. ILolainJ LJi/ev _
AIiddre;s.. ID.i (ibci+ha/lr` cT Ccjmriarrv.. S Lt>reJi^e '#ot>.{:^4 LLC
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Zjipcode.. L1 6 Fax..cjrty.. €f,. Ljc,I€ sha[he:.h
Phone No.zipcode: 3L146r7 Fax:
E-Mail:Phone No `) 7 7_ -2€6 - 9ST65T
Fill in fee simple Title Holder on next page ( if different E:Mtl)_.ShDye/./`eroc>{i`u4q&¥c?)oZ),Cdii4n
from the Owner listed above)State or County License CCC `/ 3`? /// a
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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:'2``#j`.i:?..ttt};'h}'`O:.I?:.`ii.}t/:.L'jjT£;:.\".*1,%¥'..€~a);',DESIGNER/EN'^:`¥),isl`u',`,£,'~|Y./`,.2i'rA``ti:.`,`=!` i.-`,:^..:'vrr£._'.:+j|,f.:?`:.Tzi#itl7=`=,tl;'il ..a*j`.I,I?+.toi^|f:{/LA-`rT',`{,.".,zr,t`{ !,.thud:,i/. ^ /r I,\`L}`.,,`vi£.a,`., j|^/, a. _. ,.. r _ ,. .,`, ` ` 1,,. . I ,..GINEER:NotAPplicableMORTGAGECOMPANY: Not A
pplicable
Name:Name.
Address:A,,-
city, State: -Zip:Phone:City : State :
Zip: Phone
FEE SIMPLE Tl TLE HOLDER:Not Applicable BONDING COMPANY: Not Applicable
I..-Name.
A.I-Address.
City:C,ty,
Zip: Phone:Zip: Phone:
OWNER/ CONTRACTOR AFF lDVIT: Application is hereby made to obtain a permit to do the work and installa tion as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
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ln consideration of the granting of this requested permit, I do hereby agree thanaccordancewiththeapprovedplans,theFloridaBuildingCodesandSt.Luclet I will, in all respects, perform the workCountyAmendments.
The following bulldlng permlt app icatlons are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory iises to another non-residential llse
WARNING TO OWNER: Your failure to Rei#ffi::in::`#s:t:oi!s:t:enger;n:iF:yr]eoA::,cord a Not:ice of CommencoticeofCommencement#embee::jrnegtweo:jkrsotrj#:ffie#::#|eaYer:::tltion.IfyouintenvourNoticete::tina.Ti:#f!c|:ofCommence forcrecords of St.ancing,consultment.
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Signatureofoifuner/{=::;/ContractorasAgentforowner S18nature of contractor/LI _~
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Type of ldentific ation Type of lde ntification
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATERECEIVED
DATECOMPLETED
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