HomeMy WebLinkAboutScan_0182All APPLI BLE INFP MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a
Permit Number:
�o Cc r-�E,E
l_. R� _t
L° L 0 C L L tti - ti
Building Permit Application
Planning and Development Services
Building and Code RegulationDivision Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Site Plan Name:
Project Name. _
DETAILED DESCRIPTION OF WORK:
L
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_,,,Mechanical —GasTank _Gas Piping _Shutters
Block No. _ c�N CX -
Y
indows{Qnors — Pond
— Electric Plumbing _ Sprinklers —Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ _ Utilities: _Sewer _Septic Building Height:
OWNER{LESSEE:
CONTRACTOR:
Name
Name:
Address: a
Company:'r'�'. .
City: State: �
Address: . i
Zip Code: Fax:
City: Stater( -
Phone No. -
Zip Code: Aog4-[q.q� Fax:
E-Mail:
Phone Nof-T7 a ` L[S 3' L X�(V—
Fill in fee simple Title Holder on next page (if different
E-Mail Stets I rn 1
from the Owner listed above)
State or County License -Fi_
n value ui cunscrumon is csw or more, a ntLUKuku Notice or Commencement is required.
If value of 14AVC is $7,SDO or more, a RECORDED Notice of Commencement is required.
SUOLEMN1'AL CONSTRUCTION Ll 'SAW IN (7Rl IA7IDi :
l�ES[GPdlrlf ENGt��o
Nam e -_... Ivot Applicable
Address:
City:
Phone State: r
-------------
FEE SIMPLE TITLE HOLDER:
Name: .� Not Applicable
Address:
City:
Zip: Phone:
J Certify
C®NT$iA O AFF$i�i�IT: Application - h
t certify that no
[MORTGAGE COMPANY;
Name: -- Not Applicable
Address:
City:
Zip: Phone: State:
BONDING COMPANY.
Name: _._._Not Applicable
Address,
City:
Zip: Phone:
is ereth made to obtain a permit to do the work and installation as indicated.
work, - or installation has commenced prior to the issuance of a permit.
St, Lucie Count, makes no representation that is granting a e
which is in conflict with an a
rU Ure• Please CORSUIt with PlIc ['tome Owners Association and review law deed for any restrictions which nla
Y pp [cable }Iome.Owners Association rules, bylaws or and covenants that may restrict or prohibit such
p rmit will authorize the ermit holder to build the subject structure
In considers#ion of the granting of this requested permit, i do hereby agree that i will, in all respects, perform the
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. y apply.
The following buildingwork
accessory permit applications are exempt from undergoing a full concurrency review -'room additions,
structures swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
1h1Aimpro 'i® OWNER Y failure to Record a Notice of Cornrneneemerit enay r�s� Paying improvement to a . r
Lucie C4un a y p OPerty. A Notice of Commencement mu P V ng twice for
pQ tad n thelobslte before the first inspectio . if ouQco nd i obtain the ufinancing, coof St.
nsult
With lender ors a#torne before cammencin work or recordfn vo r lv en„� / �-
Signature of P nerJ Lessee Contr or a' Agent for
STATE OF L R$CA�
COUNTY F � 1fefore
'WKn to (dr armed) and subscribed me of
I°� h icy res2ncP or online N rszation thisay of ta
� 202� by
er y �
Name of person making statement.
Owner — I Signature
Personally Known — oR Produced identification
Type of Identification
"eorarY Public- State of
Commission No.
REVIEW, ERONT Z@qn`
COUNTER RPVIIPN
L MO s
111
6Z
rem
STATE
colif '
Sworn to r a armed} and subscribed before me of
al resence_o Online Notarization
th s d of
20* by
Name of person 'Making
Personally Known — 1 OR Produced Ide ti cation
Type of identification
Produced
{ ign are Nota
ommission No. N YF r1AC&2lacfmwda
o Karl MC��
eo Expires Osf2el [ W938
NS I VEGETATION SEA TUIRTLE MANGROVE
EW REVIEW REVIEW REVIEW