HomeMy WebLinkAboutManonarchy PermitAll APPUI .ABL_ II . ] MV} T AE COMPI. TgP .FOR APPLICATION TO B9 ACCEP-TED
Date: l 2� Permit Number:
a�
Buldinge>�nt#1ica to
Planning and Development Services
Building and Code Regulation Division COI71I' erCiai Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-x.553 Fax: (772) 452-1578
PERMIT APPLICATION FOR::
PROPOSED IMPROVEI+IFT L0CATI{} .
Address: -
Property Tax ID #: g8r- -� '•�� p Lot No.
Site Plan Mame: 1 Block No.
Project Name: - i&,fi— k �fn�
DETAILED DESCRIPTION OF WORK:
App l k6lC
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION;
Additional work to be performed under this permit- check all that apply:
_Mechanical _Gas Tank — Gas Piping _._. Shutters _ _ Windows/Doors � Pond
-11-ectric _ P ulul mbing _ Sprinklers Generator
Total Sq. Ft of Construction: f � / .raollSq. Ft. of First Floor:
Roof Pitch
Cast of Construction: $ -%j U1/y Utilities: —Sewer _Septic Building .Height:
OWNER/I..iESSE€.GQ
I' aiTRACI`OR:
Name :
Name:' l 1 Y
r
Addres 4 ` 7I—Aw-.
Company:
6 -hr
i
City: tklhu 6- State_ J
Address: I+
Zip Code: , ` Fax:
Ci
City:
State -
Phone No.
Zip e: -�3W J S f Fax:
E -Mail:
Phone No `
V
10
Fill in fee simple Tale Holder on next page (if different
E -Mail
o
,` —. tv 4—
from the Owner fisted above)
State or Cou my License.
- (I 1.5711f)A3
_
If value of construction is 2580 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.
SUPPLEMENTAL CONSTRUCTION UEN LAW INFORMAnOW
E FTS PP14cAb MORTGAGE COMPANY7 � Not Applicab4,e
Name,
City; tam : City -,t
�p'hss:
FEE SIMPLE TM.E RMER: _N-ctApp�xable 0ON01ING COMPANY: Not ApOkable
t W NW CONTRACTOR AFROV� 4 �oy nude to obum A PerawW V wort V4 ivma .
I ctnov that no ids at *t5il-vulton had. ti ,gid prior to Vve Aukow of
j�.�is.
to cvr*kjv*tkw' 04 V* w" Q# 04S r r 1 y M* VWK a*W. in 64 talk r
arc wrath ow'm 5'SvAdcodft t e cadr-l(Amw mw
T W pwrm4 ,V040bWm of ,t ;9 from ut —O-T�g a * c:t%xwT("-KV ar'Arw.. room ;cdvom
WA RNM TO OV4ftM- Yow fags to Retwd a N*tK* of t ffmrnmAA in Prm twkw for
4 ,Xt l to VWttyY A Notke of 0Dmxnen"nmM must be mcorded in the putftc wards et St
Lu6e County and gmted *o the ' fo d* fitV * - tf YOU ink to
F -
STATE Of F1
COUP OF
P�,yuc a4 �,
?@bv
*t
vv* 01 k*m&
P4-. .:..
�' a
STATE OF FtORM
to lot &lJmWdj V14 xUkM-lnt*d ov Of
"= w nzo 3
x-' ( 5,ai vit tai
12
PERMIT# ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
•
Building & Code Compliance Division
.IWO- Y BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
,-, Cc
(Company NAe/Individuat Name)
the ELECTRICIAN
(Type of Trade)
For the project located at
have agreed to be
Sub -contractor for 'q' orv''
(Pfilnary Contractor)
(Project Street Address or Property Tax ID m)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
hfifing Change of Sub -con actor notice.
OR SIGNATURE (Qualifier)
RICHARD A. ADAMS
'RINT NAME
e6_G I f-,7,0-? r
COUNTY CERTIFICATION NUMBER
State of Florida, County ofha�M +�'�
The foregoing instrument was signed before me this I day of
,xa`0by tll - G
who is personally known _1Lu1 has produced a
as identif' Son.
STAMP
ature of Notary Public
Print Name of Notary Public �^
,„RµYPQ,y, tFTklr-':ASPA!if r,iNG-WILLIAMS
_riv ti' # GG 096019
Revised Ill?6!2616 w.� '; Ei(f W3 ::,;,Ieil 11.2021
ar" Bonder! Thru Budgel Notary SWAM
— aelm 9�_
SUB-CONYIZACTOR S[ NATURE (Qualifier)
_30� �� CAacV--0
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was sig d before me •s day of
fie. 20A b a D
who is personally known _ as produced a
as idM
- STAMP
Signature of Notary Public
L f3 ,�
Print Name of Notary Public
CAROL M. ADAMS
,. MY COMMISSION # GG 223226
EXPIRES: July 16, 2022
Sandod Thm Notary Public Underwriters
PERMIT# ISSUE DATE
VNTY
1 P Jft
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Zf'E- r/a-/Zt hi'oe7 " huc- -
(Company Name.'Individual
the PLUMBER
(Type of Trade)
have agreed to be
Sub -contractor for ekr�.�� inpf 1 rnp
(Primary Contractor)
For the project located at A412.74 i bDi- 2wo b7
(Project Street Address or Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing Df a Change of Sub -co actor notice.
i
CONTRACTOR SIGNATURE (Qualifier)
RICHARD A. ADAMS
PRINT NAME
e-6 C- /.i'�!-6 7l3'
COUNTY CERTIFIC:A"I`ION NUMBER
1
State of Florida, County of
The foregoing instrument was Signed before me this day of
who is personally known -Z.r has produced a
as identi cafion.
STAMP
ature of [votary Public 7
664a ' ; l f f C} i Irl ¢'�`
Print Name of Notary Public
Yrgc LETRICIASPAIII IN&WILLM
* MY COMMISSION 9 GG 09MO
Revised 1111612016
qw 1_I(r'tr (SAl+rl 1!1.2021
' fsd Handed11xuuudgelKu1BfYSeNI=
S6-�CONTRACTORSIGNATU (Qualifier)
-:::5_ aS%,�4 F 7' t '- 7
PRINT NAME T
C'4 -C /y�l /03
COUNTY CbWf1kICAT10\ �%ti��/�M1/3bR /-�
State of Florida, County of /`ZL2-�'�"i r l
The foregoing instrument]was sgn d before me this) day of
zfl C� lu° I [r L
who is personally known or has produced a
as identifin.
�te_1'3' STAMP
Signature of Votary Public
Print Name of Notary- Public
GAROLN
. ADA44S
.i MY CUIi}MISSIQN # GG 223226 f
EXPIRES: July 16, 2022
Bonded ihn, NotM y Public Underwriters ,