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HomeMy WebLinkAboutScan_0196SBD�sldf All APPLICABLE iIUFQ MUST BE CQMRLETI~D FOR AP--------------------- PLiCAi'lQN TO BE ACCEPTED Date: Permit Number: `> L um Ple'nningandDevelopment services Building Permit A lication Building and Code Regulation Division Z3 Comm 0o V1r91n10,4Venue, Fort Pierce FL 34982 2rCl0l Residential Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR; b j PROPOSED IMPROVEMENT LOCATION: Address: Property Tax ID #l; Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: N New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: mo-C L iCet� 1 Co Cot No. Block No. 0 2 �% {�/c���aL n b (" 7 • C / 9 Additional work to be performed under this permit -check all that apply: C0,6 (r) 42-+S ,Mechanical —Gas Tank —Gas Piping Shutters .� Windows/Doors — pond — Electric Plumbing —Sprinklers Generator Roof _—. pitch Total Sq. Ft of Construction: hh Sq. Ft. of First Floor: Cost of Construction: $ V Utilities: 4 Sewer O--Se tic Building Height:.WE CONTRACTOR: City; t Stater Zip Code: Fax: Phone No. 3� E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name:_6�� Company: City: _����.^��„ Stater Zip Code: Fax: Phone No -7-7 J," 145 LC� _ £-Mail 5 �� �( rMn i`V State or County License I value of construction i5 25W or more, a RECORDED Notice of Commencement Is required. If value of HAVC 15 $7,500 or more, a RECORDED Notice of Commencement is required. jpijsTRULiIrFV [qW, DESIGNER/ENGINEER: Name: -._. Not Applicable Address: City: Grp.phone State: FEE SIMRLE TITLE MOLO Name: -__. Not Applicable Address: City: Zip:_ Phone: IC}R CATION: MORTGAGE COMpANi": im me: Not Applicable Address: City: Zip: phone: Slate: _� BONDING COMPANY. Name: —Not Applicable Address: City: �1NN£R/ CONT zip' — ----�� Phone: l certify that no work �OR installation D as commenced €s hereby made fo obtain a e St. Lucie Coun menced Prior to the issuance of apermit.P to do the work and installation as indicated. which is in co makes no representation that is granting a structure. Pleas consult any a Y PPlicable Nome Owners Association rules bylaws Oran an covenants that may restrict or prahib€t such g germ€twill a thorize thedpermitholderto build the subject structure Your Home Owners Association and review your deed for any restrictions which nta a o cture in consideration of the granting of this requested permit, I do hereby agree that € will, in all respects, in accordance w€4h the a Y PPlY• h pproved plans, the Florida Building Codes and St. Lucie Count The following buildin pp p nts. Perform the work accessoryg permit applications are exempt from undergoing a full concurrency review: room additions, structures, swimming pools fences, nces, walls, signs, screen rooms and accessaryu ses to swimming Y failure to Record a 1y®tice of Commencement may Aend another non-residential use improvement to yo r o ert . Lucie Coun a p p y A Notice of Commencement rnuaying ice for with lender or a a tar a before I" theoc©rmmencrn th f orr sp din ' Q e rthe public records of st. A !f ou obtain financing, consult r N rNr.4,. ___.. Signature of p ner/ Lessee !Counr or a ggent gor Owner STATE 0F� SigSig unat rere C®LINTY , I RIDA R 16 STATE 0 S m to {qqr of armed) and subscribed before me of this > h sir r "Oresence or Online N tarization day of 202 by Name of person making statement. Personally Known _ 3� OR Produced identification Type of Identification -�_ Commission No. � REVIEWS FRONT COUNTER w�'�r\� L MO/ p1SSf0 ,� Y2sZaN 1E I Sworn toVal firmed) and sub nbed before me of byese )ce or Onl€ne Notarization '��iT -0-Fby Name of person making statement. Personally Known Type of ldentificatia'n ' OR Produced fide t€ cation Produced { ign ure Not, :ommission No. Kotary ed R' �� FlQriea e Q, MMoaa 987938 VEGETATION I SEA TURTT_E® MANGROVE REVIEW REVIEW REVIEW