HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO.Q.,MUST BE COMPLEttl5fOR APPLICAiION'TO1 BEACCEPTED
Date: Ind j 0.15.1
"PerMit.,OpMber.,
4 Cl_IVED
RECEIVED
e-eA UI
SE0�01.BuIldigPernAt.
............. ,'P.4z
Planning and Developirefitservices County, Perzm9
ittin ;I
Building, andc6* -Regdlation&vWon
2300, Vir4,lnia Avenue, Fort 'Pierce ft 34982
Phone-, (77'2),462� 1553
Fax'- (772) 462-1578 Commercial V1, Residen
0,41,
tial
PERMIT TYPE
V1%
te,P an Name:
Block —No::..
-Project Name-.,.
w
401
Additional: work to be,performed under this permit— ch eck.all,that.apply:,
.—Mechanical _-GasTankGas Piping Shutters wh, ow /Doors
Electric Plumbing;
bI"n'g! $Prinklets _Roof Pitch:
Total'Sq. Ftof'Cbhstrudfion':,', Sqrt.,,6.f,Ojtst:Flbor:
C _C r septic 'Building ,1Height:
Pq
ga
Name
Ad6es (D11
om pa ny*,,
City: dd�
- 'A re#
U
Zip Code:,. �Z 90-7 Fax: R6 �'_ aip.EL
Phone No. Fax
Zlo,-Code7
E-Mail: r eA-H a r C)r-lt ri C012" Phone No
Fill in f661.siMOle%Title,.H6lder d j,�
on irent E-
if,diffL a
from"tlhe'Owner listed,,abq,v6). "
State brCounty
If Valub'df construction ",11i$i, C?f(oninfqk. M!T
if.-Valie ,of HvAd!s,"'$t'*d 'OJNotice of eln n x pqsj
Name:.Narie _
Address: Address:,-
City: State: Cit ":
y
"ZIP:, Phone Zip:
FEE SIMPLE TITLE HOLDER: _ Not Applicable . BONDING
Marne: Name:. "
Address: Address;
City: —
City:. ,.
Zip: Phone:., Zip: .
OWNER/'CONTRACTOR AFFIDVIT:,Application is;hereby made to:obtam a
I"certifythat no work or installation hascomrriericed prior to the=;issuance;of
St., Lucie Countty�r makes no�representation;that is:gra"nting a permit will authorize:
which is i,n:conflict with.any:applicable Homeowners Association.rules,Fbyiaws"o
structure.Please.consultuvlth.yourHome ,wnersAssoci6 on an dreview,your.dE
In consideration,of'the granting of this requested=permit, I" do hereby agree"that;I
inaccordance"with the approved plans, the Florida Building Codes=and St's4LUcie:C
The following:building perfnit applications, are exempt from undergoing a;full con
accessory.structures, swimming;Pgols,-fences„walls, signs, screen rooms a'nd acci
b,
STATE;OF FLORIDA S1
COUNTYOF_
The, forgoing,instrument.was acknowledged before ;me ;Th
this ] .day of 20M, by: hI
Name.of`person making Statement:. Na
Personally,Knowm. 1111`�,%.. PRpioquced°Identification. Pel
Type of Identification Tyl
Produced Pit
=o
Commission No: 19
REVIEW$, FRONT., ZONING.
COUNTER". , ;REVIEW' .
DATE
IECEIVED , �U aFin
COMPANY: Na Applicable
.State
6M I,NY.; _Not Applicable;
P,ho"ne;
►ermitto,do-the work.and mstallationas indicated.
le permit holder to build the-subject'structutd
and covenants,that may'resteict or prohibit"such.
d for any, restrictions,which may, apply.
wll, in.a'll respects, perform thewoek,
unty Amendments
arrency review::room additions,;
sory uses taxi other:non-' resi"dential,use
ilENCEMENT ,MAY ;RESULT IN YOW110AYING
OMMENCEMENT MUST; BE RECORDED ARID
I INTEND TO.;OBTAIN FIRIANCING, CONSULT
ICE:-' ,F<C®IN�?�R1ENT n
ntr'actor/Llcen'se Holder
going instru, rit.was.ack ioWIdd1ged before me
%day ofI n-; . 20 by
i
°qof persoli making statement
V
ientification:.
SONJA LOUISE PEDR T1Y��g�r ure ur ivotary Yuq e= 5ta a of bf I ) •_ MY COMMISSION # F
Notary Public EXPIRES: of lorlda ° EXPIRES: May31
Commission # GG 14 8,Vorn ' sion No:i �� �(n � —1 „�a � J%9 j Bonded Thru Notary Public:
My Comm. Expires Sep 3;,2021
aordedthroughNatonalN6dryAsSn, k
s
SUPERVISOR `PLANS:' V,EG,ETATI0N SEA TURTLE MANGROVE
'REVIEW REVIEW REVIEW' REVIEW REVIEW
y�
i