HomeMy WebLinkAboutBuilding Permit App Alt APPLICABLE INFO MUST BE COMPLETED FOR APPLICAT4ON TO 8E ACCEPTED
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Building Permit Application
Planning aanai Dewippment Sex es
for -merciai Residential
2300 Virginia Avenue,.Fart Pierce.FL 34982
Phan:�772)4621553 Fax:t772"j 462-1578
PERMIT APPLICATION FOR:
ROPC SED.[(/tPEidtfEIVtENT LOCATION
Property Tax I##:: NU.. 907.. 00 4-7 D oo,X Lot No.
Site Plan dame: 6 lei 11 t-aza Work NO-
Project Name: Li°G �Tnh>7son
OETAf OCIRIt '!ON O OR
WL
- WaIA
New Electrical Meter Second Electrical Meter
CMISTRUCT,ION LN Oft AT
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas tank _Gas Piping _Slhutters _Windows/boors _Pond
Electric _Plumbinnnlgn _Sprinklers _Generator _L/Roof Pitch
7otai.Sq.Ft of Construction: v -I f Sq.Ft.cif First Floor: 1100 40 f
l nrfi.rif nrretnr rrt�;_ `o�SkJIJ. t ttr�tEae S�trrar -Septsr pr7yliq rr ,;Aigh
OWNERILESSEE:. C(JNTRACTOR
Name U 1 t, lee, / w-) Name: r e,I 770A (�
Address: Cn) a nl7�f r!G� Company: f�}t 'erv1 ' CL
City: t- r • C"l�P '' StateJ � Address: ' l
.
Zip Code: Fax: Cif: I e State: F L
Phone No. Zip Cade: Fax:
E-Mail Phone No
Fill in fee simple Tine Holder on next page(if different E-Mail
from the Owner listed above) State or County License T
if value-of construction is-2500-or more,a RECORDED Notice of Commencement'is required.
Af va4ae of-N VC is$Z50 ormma,a RECORDED.44N.-tice ofCca-uneiicenn ent is reequared.
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GES(G ENGINEER: Not Applicable M fiGAGE.COMPANY: _NotApplicafale
Nam: liar»
Address: Address:
City: State: City: State:
Zip: Phone Zip: Ph
a SEE SIf�, P�E a IoE :OI.OERa f 3ot Rg tica' 'e BONDING Cf�MPAW,.e Not_Ai_�phcab
Name: � � t�:
Address: Address:
City:
Zip: Phone:— Zip: Pbo e:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work orinstall-ation has commenced prior to the issuance of a permity
c�� - '.A 4: � �i rs�t r� � *�,k—jr pila,.s, ' � iAK SSCt covenants t may_G@striitt�i. u£t such
aAI..Lucie Count makes no e r� ti that isgraVi mitg aperm�4 will aut i �. he rixi__holder to'build tt sob ectstructure
I ibit su..l
vff-,;x �is;i:ue al.rI,.a.W:V wr, ._ ......loll.
structure.Please consult with your Home Owners Association and review your deed tdr any restrittions woiC4 may apoy.
In consideration of the granting of this requested permit,.1 do:hereby agree that I will,in ail respects,perform the work
In accottame with the approwd an ,the EIt?ri€a gwldft cotes and.5:Lucie County�#irieri ments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your i ilure,to Recorcl a Notice of Commencement may result in paying twice for
improvements to your property.A'Ndltice Commeri r�must �oMed in the ubffc records of St
?ur'!e C-P!In1+,,a'tr�.P tet�_0;t'he'Jo bsite before the f#t-st i nWdlon.If you intend to-obtain f3nan-cing,cons uIt
with fender or an attorney before commencing work or recording our Notio of Commencement.
Signature of Owner/ ssee/Contractor as Agent for Owner Signature of C Oraco#License Holder
a A
STATE OF FLORIDJk STATE OF F RI
COINTy OF t✓l�Q`�. 1 OOtUI11' O Q {
r 4 s
Swor a(or affirmed)and subscribed before me of Sw-or oo(or affirmed)and subscribed before me of
Physical P ence..or Onli Online V yslcal Presence or Online Notarization
this 3.s r of 2ozo b • W20 tey .
o Name of person making statement.. Name of person making statement.
tL
a , Per s anally Known OF;P,od;uced'-Identification , Pe r ky Known f3R Produced,I dentific r�
2r c T, X a�atfi a�?.a.� i Tar nr a_� rr3 a t :d
Produced rV��.- Produced o 9.`6°--
E 0,0 m
Z a N
A LcU NG7
Z i{` (Signature f N tary Public State of Flori (signature of otary Public-State of Flori a} o
• r Commission No E5 -77C tZ) (Seal) Commission No.GG .7iVj7 (Seal)
REVIEWS FRONT ZONING. SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE'
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW' REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. ,