HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COIVIPL�TED FOR APPUCA-nON TO BE A02EPTED
?date:
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Building Permit Application
Rurl nyr and Code Reguiuhron jX-Lasiorr col'r meE lal RP_5id e rit al
Z3W 14 rrid Avmuer Fort Pierce F1 j4%7 —
Phone: I T7.�) �--1553 Fax; ({72) 2.-1578
PERMIT APPLICATION FOR: - -
PROPOSED IM PROVEM EN-r LOCATION:
Address: J. 4 •....�_N Q-- e -E
"6 q, %
Rropem Tax ID #: I-3rY6 .563 — --� -� %'I — 0 — Lot 'Ko. 61
Site Plan Name:
•1�rojtCk Name:
DETAILED DESCRCPTION OF WORK:
-N-ew Electrloal Wter _, 5ccond E lectrir nJ Wter
CONSTRUCTION I NFORMAT[iDN:
Additimar work to to perl'ormed under this perrnix — k aII that apply-
Blorl No,
C• n r • t
_Mecharticaa —4:3a5 Tarpk _ Gas Piping _ Shutters _W rKtDwsf Doors _ P00d
rectric : Plumhlrg _ Wrilders l enefator Rant pitch
Total Sq_ Ft of Corrstructicm:
Cost of C0n$MG#IOfl: S - •`
OWNERJLESSEE,
Naane._.. CbLc-q I 4Au(14! V'k _
Address- 6L_ (\, �r
Zip Code- _ !? %j JS h Fax: AJ i Or
Phone No_—
EaiR.
Sq. FL of First Froor-
Utility - _ Sewer _ Septic
Fin erg fee simpl- Irkle Bolder an rten pager if ditferent
From the Owner Imed above)
Rui Iding Height -
Name:— f n^15e%
Cnrnpany. , c +L + ixi�
city, V-�- P;
Zip Code; f .;I- Fax:.,
Pitione No
E-MaEl r�
.State or Cour4 License
If value of construction is z oo -ar rrK!3re, ;Ui RECORDED Notice of Comnuercement is requbw,
If v2Iter Cif HANG is $7,500 or more, a RE[DRDED t,1 im of lZammememerrt is required_
SUPP EM ENT AL CONSTRUCRON LIEN LAIN I NFORMAT Q N:
DESIGN ENGIfV EER: _ Not App lira hie r MORTGAGE COMPANY: Not Ann I iea b:c.
Name;
City: State;
zip; Phlx'e—
FEE SIMPLE TITLE HOLIER-- _ N of Applicable
Name: _
address:
City,
Zip:
Nam
Address:
Cfty_ State:
Zip- Phone:
N01 NG COMPANY: ,Not Appkabde
Name:
Address:
Zip_ phat :
4VVIYERI CONTRACTOR AFFf DV rT. Application is hereby Made r3 Obaain a permit to do the work aFW insWfo ion as indkated.
t ierlily that m work or instalJatiore -'=} uommcnctd prim to the issuance of a perrni:t,
St- Luoc �-uy�ur�makes no : epres-rit�ti-on text is granting a pemiit wiI! auth�rirr th-u p�crm it holder to build the subject stYud Urn
which is in oonflirt with ;hny iiipplrcable Homm Ownem Asr t•on ruk-5, bylaws or and ooti+enaret& th$t rr n rt-�d-ict -or prohibit such
streaure. NOR cvnsall with yDu.r Hoare Owned. Am dadon and review your deed for arryr rt%triubo 5 which may apply.
rn consideraatim of the gfantdtE of 1'hi; requested permit, I do her&byr aRrcne 1hal I will, in all respedb, pH- free ti the ++work
in accordance with this 'iippr<3wcd plans, the Rarida &Jildartig Cedes and St. Lucie County Arnendmertit�.
The following huddaw, peTrn it applications are fc f hom undergoing a hall roncurm. my review; r-ocrm addk4oms,
$h "mory structures} swimming prM5, 1cFKrs, walks, fgnk screen rim% and aizi:c;sory uses to anothF.T ;norrrk-�denfial use
WARN tNG TO OWNER: Ypurt fabuure W Fteowd a Nalke of Cummenpement may rmWt in paw twice trrr
im prwernents to your property. A Notioe of Co rri me nee rnent must be recordi�d in the publir, records of St_
Lucie County a nd posted on the j o bete before the first i rispeclo - K you intend to obta f n fi nancirn& corksuJt
with Iende r or are attorney re cons mend ng wo rkour�ornrnerv�rne rrt.
- --,
Signature of Owner/
fu�OW-r ,--5�n�GrC of
H6Ider
STATE OF FLOI UDA I STATE OF FLORIDA.
COUNTY OF . a{ r _ COUNTY
Sworn to (or affirmc4l) and subscribed before en-u -of Swo to for affinm�w
dE and hscrihed before me of
Physiml presence or __.. -Dnline Notarization Physical Presence or _ on firm Notarization
this _4tdayr of � 24 by this Lr day cl ! �_ .. . 202# by
Name of person m"lung 5tal-rm-Ent_
Fie Tonal IV Known p4L OR Prod
'fype q1 1-dcntGFication
'5r�i nature of
commission [�o.��+-e.�,4k�'1�
REVIEWS FRONT
ci)uN FE R
�A FE
DATE
COMPLETED
Wr
REVIF W
Narr7,m. at person making statemenL
9�ers.anaky Kngwr. L-� OR Rro+duced
Type of Identifir-ation
Is
prodllte`d
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[Signature of Notary Pudic SJ w* 9F Raii-Wa }
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RSI VR� �" I TLI KU I "RE W REVIEW
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