HomeMy WebLinkAboutMascara Window Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services '
Residential_
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address
O
Property Tax ID #: Lot No. O
Site Plan Name: (a z-A Block No.
Project Name:
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A-t.U6 Z
1
SFI i70d dc'A 40. 111-MIZ . LI
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/PAtora _ Pond
_ Electric Plumbing —Sprinklers _ Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $C ; Utilities: _Sewer _Septic Building Height:
_GONTRACFOR - —
Name �A.>\A MPC A1=�4
Name: Oro �:�`emvr- i�
Company: 'Fov�i vrtcn4� CcwST
1V
Address: %L)C I'A 46k"SI�
: 3G h06L of ✓tid: k
Address
City: — Z— t State:
Zip Code: 3'f 01 �`i I Fax: . _ - _
City: tutu _Stater
,ff
1iZ �iLnS ' S'jl�
Zip Code: 34911 Fax: )12-Y66 -C3 Zs
Phone No.
Phone No 77Z_-Z1ie8
E-Mail:
E-Mail 2FiYrvw,J b Z`r e 3 � tk Sc 'zl NZ
Fill in fee simple Title Holder on next page ( if different
State or County Ucense CRQ= 19 ;
from the Owner listed above)
If value of construction is 25oo 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.
MORTGAGE COMPANY: _ Not Applicable
Name: LAt,J56,4 --;Ny sTiGc-s Name:
Address: F� t i� o 9IO aT• Address:
City: mGatc-r State: P1 City: i State:
Zip: '3311,(o Phone Zip: —� Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: P e: 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.
St Lucie County makes no representation that is granting a permit will authorize the permit holderto build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work
in 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 concurency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory use to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender nr an attomev before commencine work or recocdine voimNotice of Commencement.
Signature of Owner% Lessee/Contractor as Agent for Owner
Signature of Cont ctor/License Holder
STATE OF FLORtpup
J\�fJC \L
STATE OF FLORIDA
�� Lo C_\<'
COUNTY OF
COUNTY OF
w m to or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
hysical Presence or Online Notarization
X Ph��srcal Presence or Online Notarization
�i his _ day of N01%X 2Q0 by
thi S t`Tjay of C, by
I20_�a
Name of person making statement.
Name of person makingktaatement.
Personally Known >_ OR Produced Identification
Personally Known —$_) OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary PuBlif AUMUMANgnature
of Notary Public Sta> of id
,'w#r 198133
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Commission No. Q& � e` s a
, �* March 20, 2=
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Commission No.� lo, Q °� ah�d �p
an
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 575720