HomeMy WebLinkAboutpermit.application (2)AIIAPPTICABTE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
LLICnE
Building Permit Application
Plonning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (7721 462-L553 Fax: (772) 462-t578
Commercial Residential X
Address:{;baa iraritri tr.t fir,,,ri:* F u i'l'-'l'{ 1
Property Tax lD #:i 3 ofu 5rttr '
'3
' D*A-b Lot No.-
Block No.Site Plan Name {Yl a rgh,r.e iln E N)CIs6
Project Name: I{\AEgt{& CH&E'!.\,.q 86. - , *., . - ,
ut-tr Oii l'. 3'iFrjirr <,e{.f 6 Kh)
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit - check all that apply:
XMechanical - 6as Tank - Gas Piping - Shutters
- Electric -
Plumbing - Sprinklers - Generator
_ Windows/Doors
Roof
Pond
Pitch
Total Sq. Ft ofConstruction:Sq. Ft. of First Floor:
Cost of Construction: S cisoa Utilities: - Sewer - Septic Building Height:
value of construstion is 2500 or more, a RECORDED Notice of Commencement is reguired.
PERMIT APPLICATION FOR:
Company: &.ualli-y ftCaf fln?rtea n,,, ."
: 6Ztl4 tt4tm*tar ,PNru,1
phone No 800 7$?. ? E?O, ,, ,
State: Fr-
Fax:
()
City:ltlt ra ^, r
Name:Ayt'tlrt ,$3n,t24t rvl
Zip Code:33{t't*
Address
li
state or county
E-MaFill in fee simple Title Holder on next page ( if different
fromthe Owner listed above)
State: fil-
€t r Q9 i" '?"7
E-Ma
3{q*r
0 ',"()
City:'Fv,rt, Fl,:.rez
Zip Code:
Phone No.
tf value of HAVC is $7,500 or more, a RECORDED Notlce of Commencement is required.
Date:
-
F\
Name ,il\^A,r?h4 Lhnrnasg .,.
Fax:
')
Sworn to (or affirmed) and subscribed before me of
Name of person making statement.
OR Produced ldentification X
TVpe of
STEVEN
XCfi
firs tu,XrAd
of
,qy Comm.Expires Sep 5, 20
mission No.
STATE OF FLORIDA
COUNW OF
Commission # GG 255569
N"rticirirl Notary
Sworn to (or affirmed) and subscribed before me of
}{ Physical Presence or
-
Online Notarization
this /5 dayof fu'L,t t;r^*V ,2020 bY
fii-tward
as
My Comm
Name person rnaking statement.
Personally Known
Type of
STATE OI FLORIDA
COUNW OF
Florid;
on # GG 255569
Notary
Commission No.
'tdrar'r i
Expires Sep 5, 2022
National Notarv Assr
.l j ".. , 1.
MANGROVE
REVIEW
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
MORTGAGE COMPANY:
-
Not APPlica
Narne: -
City:
e:zip
ble
Address:Address:
INEER:
Na
CitY:State:
Zip:
--
Phone
BONDING COMPANY:
-Not
APPlicable
Name:
zip
FEE SIMPLE TITLE HOIDER:
-
Not Applicable
Phone
Na
zip:
OWNER/ CONTRACTOR AFFIDVIT: Apptication is hereby made to obtain a permit to do the work and installation as
I certify that no work or installation has commenced prior to the issuance of a permit.
indicated.
i,Ii[ifi8,i'H,y,ffifi,t:?,i".,J3fistfit'fi3*lEbi;,fi!?litg"lBtis'!il'xl:H;i:fl'li',iifi:tsl!fli1:.Ll? h.,:'i:'!?i.,i.1*i,"iTiiitttln
iii"iid,ji.i.'pjEiiiitciniutf riritfi"ri<itilFiirhioirn'eiii As-soliation and revir-lw your deed for any restrictions raihich may apply.
ln consideration of the granting of this requested permit, I do hereby agree thatl will, in_all respects, perform the work
in accordance with the ipprovea plans, the Florida Building Codes and St. Lucie County Amendments.
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
WARN ING TO OWNER:Your failure to Record a Notice of Commencement may result in
be recorded
paying
in the
twice for
ments to your property
posted on the
A Notice of Commence ment m ust public records of St.
in financing, consultandjobsitebeforethefirstinspection.tf you intend to obta
with before Notice of
X Physical
this DB day of
,^a
Presence or_-Online Notarization
202{ by
finn,nn-
OR Produced ldentification X
Not Applicable