HomeMy WebLinkAboutBuilding Permit ApplicationE
All APPLICABLE INFO, MUST BE COMPLETED FOR APPLICATION TO BEACCI PIED
Dater P.ermit'Number:
RECEIVED
Building Permit �1p ii`cair$ 20"
Planning.and DevelopmentSelvices E ST. Lucie County, Permitting
Building'and Code:Regulation: Division I
2300 Virginia Avenue, Fort Pierce FL 34942
Phone: (772).4621553 Fax:"(772),'462-1578 Commercial, V, Residential,
PERMfTTYPE:= \
Address: CrQ2V—Si��a _ Qo✓K.4-pu.lr� '(i
Property Tax ID #:
Lot No. .
Site Plan"Name:
l ,�ee1/ Si P ,
Block No.
Project Name:
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�$3A.h1F +°N.: ^;l.-�`$�z.''�'#'}*S.. x. a�*+:4 R.
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Add itiorial work.to be, performed: underlhis permit - check,all that apply:'
_Mechanical _ Gas'Tank _ Gas Piping _Shutters
_ Electric _ Plumbing _ Sprinklers Generator
E
Total Sq..Ft of Construction: Sq: Ft. of First Fiooe: _
9 �
Windows/Doors
Roof Pitch.
Cost of Construction: $ J�,.. Utilities: _:Sewer Septic Building Height:
`.`d �
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Name C i
Name ^ m,i
Address 1 i-1 �^j G t� ��-er `fir. l�l
Com an C. ti.S-1- U 1 a
P Y� n-�
Address . 91GN
Zip Code:' 2 �1yT7 Fax: (.�,(y ',� `i ,3 — �r 1';
; City.,
Phone No. — 1 3 3— _I .-IjZ
Zip Code , '3. q Z Fax: 7 7Z . 91?
f-Mail: _ De / di- 1Ii27-,g,J:tom
r:Phone-No
Fill. in fee simple Title -Holder on ne�t,page (If alfferent
E Mail `...� .Q V i I 64 -Ps.' Qn A-6t C b tlul
from the'Owner1isted 'above).
State=or County License:.13
3
at Vd1Ue OT-GonSirUGilOn IS 1.L7UU Or RlOftie, 2. KtI,UKUEU'. Notice Ot Commencement is required.
If'va-It4of HVAC 1sv$7,500 or more,xe RECQRDEg4 ice. of.Commencement is required
aim
DESIGNER ENGINEER:. N6t,Applicable MOkTGAGt
,COMPANY:. N,W,Applicable
Name: 'Name:,-
Addees's:
City: State: City:
State:
Zip; -Phone zip:Phone:
:FEE SIMPLE TITLE HOLDER: Not Applicable BONDING _Not Applicable
CPMPANY:r
Name:
Name:
Address: Address: i
City:,
City:
Zip: Phon"e. Zip. Phone!
OWNER,/ CONTRACTOR AFFIDVIT: Application is hereby madeto obtain.a. permit to do the WorkAnd', installation as ln&icaied.,
"I certify that. no work or -installation has commenced prior to the issp ance of a,permlt.
St., Lucie Count makes no.representation that is granting a permit will authorize th'e permit holder'to build tfie-subfect'structUre'
which is in conflict, with any,applicable'H6fnO'OWnet.s,Association-rdids, bylaws.( bovenahts1hafmay, resteictor.oeohlbit`§Uch
'structure. Please edrisultwith,,your,11 m ' i0ts AssOciatl6hand review your.dedd1orany'restricti which i J " -
orne pwi ons w ic may.ap apply.
In considEi ' rati6n (if thegrantirig ofihlsrequested I hereby agree that I will, in "all -respects, perform,the work
in,accordance,With-the :.i�Or,bVdd plans, the Florida-'
n' "Codes . and I. -St'Lu:cie County
The following building ; permit'applications
' ' are eexemfrom undergoing
ndergohga fuh-'cotcst�rrency review: ro6 ;addifions,accessory:strutturessWinmingpools"f�nces, walls,gns,-scredn'r ",accesoy uses to.ario.thdlt,'iio,ii-.eesid.ehfiaI use
"WARNING ' TO OWNER I :, . TPVR,. FAILURE, TO, RECORD A,, NOTICE OF CQkAE'NICEMENT, � MAY, RESULT IN,, YOUR
PAYING
TWICE 'FO'414P,OO�EMENTS TO' -YOUR ,,PRq" :MUST I 'RECORDED OF, COI
---- --- MkNCEM,ENT1 _IBE
Signature of Owner/ Lessee/Contractor as Agentfor Owner
STATE CIFfLORWA-,
COUNTY OF - " ' V,
The forgoing, instrLimept"Was acknowledged before, me
this 0- d'a'y.qf,, by
Name of -06 . r,s I on making statement.
Name°of
Personally Known OR Produced Identification Personal
Type of Identification Type of I
ProdUcecl:. -Proo�Ucqi
D,
(Signature ofNo�ry-Ppb!iCr,,atate:— _qq'a,j
Commission No.
REVIEWS FRONT ZONING
.COUNTER ,REVIEW-
DATE-
T_
P,
ac khoWl ddg6d'be.fo re,-m e
rsori'making statern "pt.
,sown OR Produced Identification,
itification
SONJA LOUISE FEN WaINU
Notary Public - State d for �Ure'& No��Iic- State of Florl C-1 3ER
MYCOMMISSI)N FF956276
6 M4',l
Commission# 1 839
G Sep I
ssioh No!, 2-:-7 G EXPIRES: A ]a) 31,2020
My Comm. Expires Sep 03rmn '0— Bond
IN ed Thru Notar} Pt ic Underwrilei
Bownded tNcugh N&600al N� ry Assn* 0 a
-SUPERVISOR PLANS'.,.'' VEGETATION SEA TURTLE MAN
GROVE
REVIEW R VIEW, REVIEW R ", jEW'
EVIE�W, EY