HomeMy WebLinkAboutBuilding Permit applicationAll APPUCABLE INFO T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: aq. 3---'.&
U J -
.. (L211 -P-'
Planning and Development Services
Building and Code Regulation Division
2300 rginia Avenue, Fort Pierce Ft 34982
Phone: (772) 46 -1 5 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: 1 7
trope T XJD #: -e
rIpcD
Mn
vv
Ir
Commercial
Permit N ti m r:
Residential
di
F- we V_L= 0 -
3Y
Lot No.
Ac �.S SIP [..o7y -Le. k1 5"rp-f-F-0d R� �)4ock No.
14 U:r. V0J1CV*'
Illffs!ar'2411 wjlnkffif4lill%ffilllll�
New electrical Meter Second Electrical Meter -
AddItional work to be performed under this permit- check all that apply:
Mechanical Gas Tanis _ Gas Piping _ shutters
Electric Plumbing _,,d1..Spr1inkJers �Generator
TotaI Sq. Ft of Constructive:
Cost of Construction: $ -j �3`7�
. fL -
U., R/
LESSEE:
i
Name Ala f-C
Address:
city: tjQ j4._ State:
Zip Code: Fax:�
1�
Phone No.
E-Mail
Fill in fee simple Title Holder on next page ( Ifdifferent
from the rner listed above)
. Ft. of First Floor:
Windows/Doors � Pond
utilities-, Sevier Septic
Dame:
Company:
Address:
city. -T�r�
Roof - Pitch
Building Height:
-----------
Mate:
Zip Code: _ 3 �! �G� _... Fax: � --
Phone No
E-Mail
State
if va I ue of co nstru ctio n i s 25M or ma re, a R E ORDE D Notic a of Corn rn ence ment is required
if va E u e of HAVC Is $7.,50 or more., a RECORDED Notice of Commencement is required.
0 W N E NTRACTO R AFFIDVff#0 Appi1cation is hereby made to cbta1n a permit to do the work and installatlo n a s ihditated,
I certify th at no wo rk or insta Ila do n has commen ced p r o r to t h e iss u a nce of a permit.
t. Lucie County.makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rulesby lavers or and covenants that may restrict or prohibitsuch
structure. Please consult with our Herne Owners Association and review o ut deed for are restrictions which may apply.
in ca ns i derati o n of the granting of this requested perm it, I do hereby agree that i will, in a I I respect,, perform the work
1 r v accorda n e wfth th e a p proved pia ns, the FI orida Bu i Id i ng Codes an d St. Lu cre Co u nty Are ndmrents.
The following building permit applications are exempt from undergoing a full concurren review: room additions,
accessory structures, swimmrning pools, fences# walls, signs, screen rooms and accessory{ uses to another non-re sidenbaI use
WAR N I N G TO OW; You r fa H ure to Kern rd a N atice of Cam me n met may resu It i n payi r tw i ce fo r
improvements to your prope�� - Notice of Commencement must be recorded in the public records of t.
Lucie County st t job a before the first inspection, If you intend to obtain financing, consult
w!th lender or an atto rney before commen d ng work or r Lingqur Notice of Commencement.
Ure of C)ner Lessee c
STATE of FLORID
COUNTY F6-7
I.!
as A&h t fie 0*fidt
Signs 0-f df LIc-ehs6
STATE OF FLORIDA
COUNTY Fr
. ern to (or affirmed) and subscribed before me of turn to (or affirmed) and subscribed before me of
W'11�1
Physical Prese ce or Online Notarizatiun .,:. Physical Presence or Online Notarization
- L 7
th d air of_ th day of20 by
C2, 1 0.,
mama of per ng statement, Name of persori -making statement.
Personally Known O Prodticed Identification Personally I nown OProduced Identification
Type of Identification Type of Identification
Produced r P r. uced
s ignature No ature of tam Public- St' Florida
.s IAY'69i
•�'�!I -Stoto Of FIQfida •
�+JAIME O IZ
Cf3winissiopState i9si d No. 444 orisson
f F(qo
„ ...ceded Ora* Nat'ohal Notary w.. e rr. 1--trey Jun 112022
Bond thr gh National NoUry A w--
EV1EW FRONT ZONING SUPERVISOR PLANS ROVE
COUNTER REVIEW REVIEW REVIEW REVIEW I REVIEW lEW REVIEW
DATE
-RECEIVED
DATE
OMPLETEID