HomeMy WebLinkAboutdemo permit and subsAl I AP-PUCAR LE INFO MUS 1 M [OM Pf FTE0 FOR AP PtGCATMIN TO BE ACCEPTED
D"l.t { f Permit Numbr
. - Na
Building Permit Application
Ptdrrning c, r; DEve)opmen t Servjtes
BuMdrng and Lb de Regufatjr n D,r&Dor
2300 Vir!yjri0 A wi rn%j e, €aFt Pierce Ft 34982
+hone; J 772) 462- 1:5 53 Fax- (7 72) 452-1578 Co m m e rt l � I
PERMITTYPE: PWr'>L"ok?
R F`51 dentin I
Add re55; _10. �+jr Or eXl/? f .At 2 f 3 ori}'f, OeAcAp r L/
P rope rty+ r ax 8I} # 1- f ' _ Lot No.
-Site Plan Plame; 3r7Lup
Additbrial wo rk to be performed i,n¢ef # he, perm 4 — Check a II that apply:
_Mecha n ir-al Ga% Tarty _ -6 L* P'Pi nd _ Shu tters _ Windows/Doors
Fiprt4r. _ P ILFrn bang _ 5prin klers
10t@ I S[j. F t .0 f CoAstructlon_ �-
Cost of Constriction: $ -'w
_ Generator _ RODF Pitch
S-q. rt. of rir%t rinnr!
Utilities- 5ewct _ S t pt lc
Build ing Height:
Name C Ala m.P.
a ddr�#x: Ja r erf� Com pang: Z A r'{ Cc, / -
Cityr: Jar 1 Vtrrr State; Addre!�5= r'
_dip bode: Fax: ICt 5lalte,4r• '
Phone No. 72-2 - 1 7 7,p (ode: _ _ Fax, 7 2 ; ',�l 9f
E mail; Ph rune. No. 7
Fill in Fee sirrGpl Tetle Holder an next page (it dEFfererrt �rn C: ! r �,fo. 6t It
From the owner listed abov-t] State or County L ioense
F Vol we of [c nsUuvftn is $2500 a r more, a R ECORDED Natice of [am nsencew'mmt i5 requir*d_
>f Val L,e 0f PIVAC Is 97,500 or more, a RECORDED NGtitc of In mmenrcm errr ip TUq uirQd_
NaMe:
Add res s
City;
Zip -
Phone
KL)t App
F E E SIMI PLE T ITLE HOLDrR: Not App
Name;
Address; -
tiP: h�rti
�Ie MORTGAGE COMPANY:
Name.
_ Addre55:
i#Y=
7i PFspne:
COMPANY:
Name-
AddFMS:
City:-
Z ip! I►
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Not Ap pl icab le
OWN E R) 00 NTRAC f OR AFF I DVIT: ApohC3iuon 15 herahV made to ah tWn .2 permi L tp da th-V vrark pMict in�tallztipn �5 i ndiuted-
I tertiFy that no -work or installation has commenced prior to Litre iiivanL*.0f.8 p�rrnii.
St. -Lucie -Coue-t wia-kei rto rr.prFienldliun I Fiu'. i% Kr,ln king ,i permil, Wil I authoriFe �e permit. holder to build the subject stiucture
whlcn 15 in c-Dnfliv with any applioAblf- I l n-e Llwnr: r5 A5xoriation rules, bw1;wws of and cove-nants that may restrict or prohibit such
str•�re. please to-�sull with yrpur Hrrrlik; Own-ers Asy4ciation and reviiie w yOur deed for any restrilftm which maw apply.
In cons,derat+on of the granting of this reque�5lf+d pee t11iq, I do hrrt- y nrtL�t th,i I I veill, in ;o11 np,peCts, pL ri4?rm the wprk
in a=rdance with the ap:l�rav&d plains, the Flu! id,+ Gui (ding CQdI-s an-d St. Lucie L.auntv Amend m"ts.
The ti-Alowing bu:.ldi ng permit applications are exempt from uMe.rgpi ng d fUl I pgnGUrrCntp Fcvitw: rupm odditims,
uccessure 5,ructurE s, swi rn r-.:ng poDls, Fences, w211i, sign. sereee, i c iam, and :' i:i:r-%L:Fry •. iv% I n :in�l ho • —)� re--;i jl,pk:.1: lJ 1,
"1rMAR N11G TO OWNER: YOUR FAILURE TO IlWtORD 4 NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TRICE FOR MP1fOVEMENTS TO YOUR PROPER 1 T. A NO TICE OF COMM ENCEMENT MUST 19 E RECORDED A ND
PO!5TfD ON THE JOB WE BEFORE THE FIRST INSPECTION. iF Y04J INTEND TO OBTAIN FINANCIN-C, CONSULT
WJTH Y IDUR �N.DER, OR AN AnORNEY BEFORE R-ECORUINC if OUR NOTICE OF C I)MME N-1 EMEpff
Ili Signature of Coy tractorf l- erase oldef
STATE OF FLO
�-TLCOUNTY OF f' f
e iQ g[}ing ; n5[rufYiQfi? WLi% Ask:" uwludgrd bl`F4rl' me
a y L� dayr of - , i-i.3 -r- 7o j � by
8 J &Yr7 l i. d + � .
N.drnr. of pvr�an making skate ment
Pvr-�t;nolly Knirwn OR Produced Identikation
Tye b. Ids j�irwltipn
Produced d}i L • —
;Signpwre & F #ary PLLblic- State of FIF kY6iYk1;G r4�TFT
}REVIEWS FRO NT
COUNTER
STATE 0f F L0 DA y
COUNTY OF_! 1• Fw ti
The cing Instrur�rtit was acknowledged before r-.e
this daw of r L � . 202L byr
d a r'Jq � 1 r- k•
Narne of perso-n maki r%g statement
Persona=lw Knawn OR Produced Ide;;dficatianl.t
Typc of Dent rlca4i n 1
Prindurcd��f����L—
(5TRi tune of Ciwv Public- 51 T of Fln-idA }
kVM LM WAM
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#{° L %1,6d Tom+ &K" NA2!y 5�nims
S;iorS No�����•� �1�}SiUISSlON*C�
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ISSUE DATF
P1. ILN \ I NG & IMF %rLL()PNI FXI SERNITC'F_S
1!-CO"rRAC ] UK A[: RFFM F.7'
. havc agreed to bC
(Cumpany N;jjue•7ndjvjdml Ni
tP� /,,, e r 5 trb-contractor for . r
('['}p� of Tr ) ft rrmrV Contrwtm F
For the pwjco located m fen 7 S cncx!;;� 1WW -
I Priij, mt Stfmi Add I e}} or Fropert'r' Tax 11) 11 1
It is und-mirood that, 1 f Ilicre 1 r. a37 p' L; fLar1 ge of S# M'S rLgardmg our part i L: i p8 tion w 1 di tf7e abL)v Fncpulioncd
projeel, the bu 1Idtrlg mid Code R t_gu Itit i on NV i sifrti (a f St. Lucie Uo i i nty M I I be ads' I Seel 13LU—wH rLE Lo the
�i fiTig of a t= harLgc o F Sulu -coal ractor not i-Ce.
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�RFti 14 7 F
f f
r v i'r' RT iCNUMBER
NIMIK or RurldLa, ",r1,13 er P-tq, r,�, r--�
The. fn.qppiag lonrurnam ,.ors sinod h0arr111t• th h 4�n er
-vLL&t , 2 D-aI t* L �_— .
w ho Is prr"itsll? Lrww•n _ *r has pmducL4t s • 0 r
m Lden+Ilrl *6n_
SL"F!-C:S}ti'I'it kC''{{]R 5 Ci ti.� L A NF {1 ii91ift rM —
PFLI 1 431v
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Col. TY l F-R E EFICAT10%, NL. xiAF. R
5A ■u ¢r Flurlda, ['mum} rr :aT j
_1 Xti1F'
Niplulare Man lNblk. � s• ��`LEEHATIM
i • W UC�30 GG %;W
lc „�„�'^`�}'a
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ry PLLMFE �"^J�
RC 1}Yy I I I?. 1..!1%
1010
the iilrMPiEN inslrume.nl "ac Ligiivil brrore mo tha d2% -Al
ri ha Is {pe.I'5nrkAIIl &rwri n or hsit prfiAq,twil a—Dy- - X
es srltnrlll{sY.r���
AMP
'11.11mlore 4f "lio1LLn F%oblle
ri M4 NEaR at NrArir % Fk bjC
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PERM11`.AL IaSU E�Lx-
COUNTY
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PLANNING & DEVELOPMFNT SERVICES
Hadding & Cedic Compffmage IDivi!Oon
INIFLD IN G PERMIT
5 un-co ,rRACToR ACREEME. F'
}� •' _ _f r }� e rr�oa have agreed ran he
Sub-conmku= fix
�
(Tym of iok l
For the prq tx E luutw at 2 2a . .
LM-
it i6 widersu)od ffiat, if there is any change of Vms FrUarding Ow pIMOPOOn With the abOwl-, mentioned
PFOj kt, the Building and Code RCAU 14110ri Di vis ion of A Lgcic C:M will be a iW pufs+.= 10 tbe-
filing Df 8 CIJMZC ofSub-contractor note-ce.
Tue£ RACTOR SocNA'VkJ ll fQMIMD +!
PONT NAMIL
121
CT91 /
Cnt' n
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Sak of FMr1ML Cowly d I hl 1
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PRFPff -NAVE
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:UGU +rl'f -CgplT1-Zf A FION NUMUR
51djf 0 Flaridq6 weer of LLT3 F-IL
T Me 1nrr�ai a� aeaerowlrei ti+�E d ldvrs ar Kim if
pnlbItY k�r a _Zihr ha PrUdKYtl ■
a �rd�IPl� ZUrIMFC- . ;fKO'
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STAMP
COUNTY
F L 0 R! D A
Planning & Developm-en t Sorvices
Build i og & Code Reg u la#ion Division
2300 VirginiH Ave
Fort Pierce, FL 34982
772-462-1553 Fax 77.2-462,1578
AhREST SINT 10E TO CONTRACTOR
ai9te: �? 121
Contnxw Name: ZAI /71
Busl ness Marne:
Address:
pity:
Zip Code:
57
Re, Job Acid ress- �
fe4 z9�17, 142 -
It is your responslhlllty to corn ply with the provi-sions of Section 469.003, Florida Statutes
nd to Igo* the Depa =e nt of Envi ronrnenta I Protection of o ny intentions to remove
a sdestos when appl Ica ble I n accord -a nee with sta and federal law,
nature & Dahe
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