HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE
COMPLETED FOR APPLICATION TO.BEA'CEPTE ACCEPTED
Date:
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Permit. Number 9 665 -
0
Building Permit Application
Planning and DevelopmentSerVices -
Building and C6de Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982 Reside al
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
Address: ZY 0(o U'r Il e L
Property Tax ID #:
Site Plan Name:
Project Name:
Lot No.-.
Block No.
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0 J
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/Door's'
— Electric Plumbing — Sprinklers Generator Pond
Total Sq. Ft of Construction: Roof Pitch
Sq. Ft. of First Floor:
c0st-Of'Coh'struction: $
Utilities: Sewer Septic Building Height:
i IV CC-) 0-F MM, r.U%r.-jm",C
Name
Cr c-
Name:
Adclreis:��', �,Lc
dress;; -1 1
Comppny:
City
State:, :Address-':'
-zip Co-d
Fax:
j
Phon`e','N6,,,' City; D State:
t2ip.Code
F x:
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.Phone No 11-
o_d
f different E- aV;,
11�in fee simple Title Holder on next page
t_�`Owner listed above) ate or,County License
If value of construction is 2500 or more, a RECORDED Notice Of Commence , ment is required.
If value Of HAVC is $7,500 or more, a RECORDED Notice Of Commencement is required.
t
Not App
Name:
Address: State:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER: ._.
Not Applicable
Name:
Address:
City:
Zip: Phone:
COMPANY:7777
_Not App licahle_
M'
ORTGAGE
Name:
Address:
State
city:
Zip: Phone:
BONDING COMPANY:
--Not Applicable
Name''
Address:
City:
Zip: �- —Phone:
k and'installatiori as indicated.
CONTRACTOR AFFIDVIT: Application.is hereby made to obtain a permit to do the wor
OWNER/ ..
I 'certify that;no work or Installation..has commenced prior -.to the issuance of a permit
Owners Association rules, bylaws or;and covenants'that may restrict or prohibit such
St. Lucie County makes no representation theat;is: granting a perm will authorize the poera restrictions,aeh ch may ap structure*
which is in conflict with any applicable Horne
structure. Please consult with.your Home owners`Association,and review agree that I will, in all respects, perform the work
In consideration�of the granting of this requested permit, I do,hereby g
in. accord'anee with the approved.plans, the'Florida Butldom undergoing a f II coningCodes and St. Lucie Ourrency review* room additions,
The following building permit applications are exempt f
accessory'structures; swimming pools; fences; walls, signs, screen, rooms and accessory uses to anothe a o� -re1Ce f `use
encement must •be recorded anrthe public rc'rordl o suit`
WARNING TO OWNER; Your.fa'ilure t A Noird t ce of Comm Commencement may result d p _y g•
improvements to your:property.. o r ot'ice of Commencement.
and osted on the Joi bsite before'the first Inspecdtion:'I ou Intend toy mme finan g,
Lucre Countt�yt,, P
,.,irKllern`dieddr�an attorney before commenc)n work'or r ° I .,
ctoi' as Agent for Owner
STATE OF FLORIDA
COUNTY.OF.
Swor .to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
d'a of 20— by
this �_ Y
STATE OF FLORIDA d �,
,COUNTY.OF
Sworn,*to (or affirmed) and subscribed before me of
%/Physical Presence or Online Notarization
this day of S 20— by
Name of. person making statement:'
Name of person making statement. OR Produced Identification
Personally -Known
Personally Known _ OR Produced Identification Type of Identification's ,�•ua,•
Type of Identification produced_/n_
Produced I i
of Notary Public- St t of Florida) .
(Seal)
Commission No.
REVIEWS FRONT ZONING
COUNTER REVIEW
RECEIVED
Notary Public- State of ri a) 1
'
ai
(Signature of
CD
maN
c) ;, Y
(Seal)
Commission No.
6� '�
I�
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c3 or"
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PLANS. VEGETATION ' SEA TURTLE
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REVIEW REVIEW REVIEW
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