HomeMy WebLinkAboutBuilding PermitAll AP PLICAI3LE NFO MUST BE iflMPLETED 1=0R A F' f ►�1:3N 4� BE permit
ACCEPTED Number'.
Date..
C�t1>ZVT II ,a
Buitding.Permit Application
Building and Code Regufation Division
2300 VIrginia Avenge, Fort Pierce FL 34982
phone- (772) 462-1553 Fax: (772) 462-1573
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PERMIT APPLICAT1O1�1 FOR:
IMPROVEMENT LOCATIOItil:
cornmer'ial
Address' , Q00 -0
Proper,.V Tax !D #: 1 3
Site Plan. Name:
Project Name:
�.DETAIL€D DESCRIPTION OF WORK:
New Electrical Meter y°_
Second Elect: ical iVleter
[n[chctUAT.ION:
LUIVJ•l ftuv c w,�
Additional work to be performed
Mechanical
Electric
under this permit — check all that aPPly:
Gas Tank
Plumbing
Total-Sq. pt of Construction:
Cost of Cc nstructio n: $
ntti►nIFR•/LESSEE:
Gas Piping
Sprinklers
shutters
Residential V
Lot No._�
Block No.
_ Windows/.Boors _ Pond
Generator Roof Pitch
Sq. Ft. or pirst'=loot: _
i.ltilities• _sewer _Septic
Address: 0
LA `• .state
rer Cam' c
Csty' YUf T Fax:
Zp code: i_1
—IPhone No.� 40
E-Maii:
rose bolder on next page (if different
licted above)
CONTRACTCR
Building Height:
mp
Address: ail state* �-
�ity: 4
Zin Code- �ItL� D( v / Fax:
Phone No Z'
, SLCL� OT urtty Li�ense�,.,� /J�
it value of constructlan 1s Z500 or more, a- RECORDED [dotiCe of Commencem®r t is requir
if value of RAVC is $7,soo or more, a RECORDED Netice of Cammencernen_'` . ecuired.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMiATION:
_Not Applicable
Name:
Address: State:
City: Phone
Zip:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City. Phone:
Zip: —
MORTGAGE COMPANY:
Name:
Not Applicable
Address: State:
City:
Zip: Phone:
BONDING COMPANY* Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AF IDVI I. Application
enced prior hereby
eby -issuance of a permit -
granting rmitmt to do the work and installation as indicated.
[ certify that no work or installs p
Iientat Home Owners Association. rules, bylaws or and covenants that may restrict or prohibit such
St Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
cable
which is in conflict with any app
Please consult with your Name Owners Association and review your deed for any restrictions which may apply -
structure.
in consideration with he apprtoved plans, the Florida Building Codes aherebnd agree
county Amendmeentsperform the work
i do
in accordance
The following building permit applications are exempt from undergoing a full cencurrency review: room additions,resid
accessory structures, swimming pools, fences, walls, signs, screen. rooms and accessory uses to another non-sesidentiaI use
sult in
WARNING TO OWNER: ou° failure to property. A Notice of Comma Notice ofencement must bmmencement e recorded in the public twice orecords of St.
improvementsYhe first
Lucie County and posted on the
before bsite commencing n twork or record'inn your Notice of Comme cement' consult
%.fi+h lender or an attorney
Signa re of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF (�-L 111 G-!,61, —
Sworn to (or affirmed) and subscribed before me of
Ph sisal Presence or Online Notarization
this day of 4 a I� _ . 20 by
Name of person making statement.
IPersonally Known OR Produced Identification.
IType of identification
Produced `
{Signature of Notary Public- State of Florida)
Commission NO.E e (,seal)
Signature of Contractor/License Hoiden
STATE OF FLORIqfkl(' I
COUNTY OF -
Sworn to (or affirmed) and subscribed before me of
Ptlysical Presence or Online Notarization
this day of L 1, lF0 _• 20 2-1 by
Name of person making statement.
Per= -ovally Known. v OR Produced identification
Type of identification
Produced
j ��
{5gnature of Notary Public- State of Fionda )
commission No. GG?&_?33 (Seat)
IROVE
I IREVIEIS IMR
REVIEWS REVIEW vEGETA7lON
I
FRONT ZCNOn
COUNTER REVIEW1vVV
GERI L CALHOUN
Notary Public - State of Florida
Commission N GG 916233
My Comm. Expires Oct 6, 2023
Bonded through National Notary Assn.
GERI L CALHOUN
Notary Public - State of Florida
Commission N GG 916233
My Comm. Expires Oct 6. 2023
!d through National Notary Assn.