HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONFOR:PERMIT APPLICATION
State: FL..
Fax:
State
City:MiraMnr
utl
Phone No
Zip Code:
on next page { if different
Slate: FL
Fax:
Fill in fee simple Title
from the Owner listed
City:
Zip Code:
COMPLETED FOR APPUCATION TO BE ACCEPTED
Permit Number:
Building Permit APPlimtion
Commercial Residential - X
FL 34982
17721462-Ls78
rt 3t. Luctc
os-Lot No.-
Block No.
Second Electrical Meter
under this permit -check all that apply:
Tank - Gas Piping - Shutters
-
Windows/Doors Pond
Pitch_ Sprinklers * Generator _ Roof
5q. Ft. of First Floor:
-
Utilities: -
Sewer * Septic Building Height
or more, a RECORDED Notice of Commencement is required.
a RECORDED Notice of Commencement is required.
AII APPLICABLE INFO MUST
s . l-uicflE
Plonning and DeveloPment
Building and Cade Regulation
2300 Virginia Avenue, Fort
Phone: (772) 462-1553 r
PropertY Tax lD #:
Site Plan Name:
New Electrical Meter
Additional work to be
f,Mechanical
Electric
Total sq. Ft of construction
Cost of Construction: 5
lf value of construction is
lf value of HAVC is $7,500 or
s
Date:
Address:
Project Name:
<aLl.a , r1lfr .s
kcn
bqEE
CONTRACTOR:owNER/LESSEE:
trtame: Brntna ful{o(lmiN.m* . Suson {Airen
-
eoaress: J 2l{0 [AaegH 'Tf,9"
-
Phone trro. 43.1.' q,l6 '] lt-lt[
zr,tqs6
Ps.t .
State:City:
* Not ApplicableMORTGAGECOMPANY:
Zip:
-
Name
Address:
7ip:
-
-Not
APPlica bleBONDINGCOMPANY:
-
Not APPI icable
Zip:e:
FEE SIMPLE TITTE
Name
Address
Online Notarization
Produced ldentifi cation I
R,N
before me of
2020 by
Sworn to (or affirmed) and subscribed before me of
r( Phvsical Presence or Online Notarization
ilnir Zr oay ot lutt(Llt-- , 2o2o by
Personally Known .-OR Produced ldentification X
BB^)COUNTY OF
of person making staternent.
STATE OF FLORIDA
Type of I
Commission # GC 2555
My Comm. Expires Sep 5,
STEVEN LEVY
National
Cormi::iirr : CC
Nctary Public
My Ccrnr. [:;:l:. ,.
througl: I'iiji;i: i i
STATE OF FLORIDA
Personally Known _
Commission No.
Name person
Signature
COUNW OF
Type of
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
REVIEWS FRONT
COUNTER
RECEIVED
.TE
COM D
I certify that no work or
ln consideration of the granting
in accordance with the
The fotlowing building Permit
accessorY structures,
WARNING TO OWNER:
improvements to
Lucie County and
no
owNER/CONTRACTOR
you
ror
ia?.1
',{!-if
t1g:y:twl"*rPirbrgFe
Cbnrrnission No.':,.- ]|;
of
City:
Zip:
HOLDER: