HomeMy WebLinkAboutBuilding Permit Application C •
All_AP.PLICABLEINFQ.MUSiT BE.CDMPLMM.,.tQR APPUCPt QO t;7 D BEACCEPTED..
Date: 2 2 4 Permit-Number.
0 RECEIVED
° 8gi1d ng Permit Appl Catiq APR 13 1011
Planning,and Development Services'
E' rmlttir. apartment
" Building and Code Regulation Division Commercial. Residentift tv
2300.1rrginia Avenue,Fort Pierce fE 3.4982
Phone:(772)4.62-1553 Fax;(7721462-1578
PERMIT APPLICATION FOR.-
PROPOSED IMPROVEMENT LOCATIIO
Address; vsm '�-PmeJYCL
Property Tax ID#: 340 2-(o 0 Z - 0'2`I(0 '000 - (o Lot No. A(3
Site Plan Name: Block No-. _
Project Name: ::fV.QCe
'DETAILED DESCRIPTION OF WORK: \
7 Vt
New Electrical Meter Second Electrical Meter
CQIVSTRt1C PN INFORMATION: 1
Additional-work.to-be.performed -undenthis:permit—check all that apply:
Mechanical _GaS Tank- _Gas Piping _Shutters _Win dowsJDoors _Pond
_.Electric _.Plumbing _Sprinklers _.Generator _-Roof P--Itch
Total 5qe_Ft of,Construction:• 5cg,.Ft:of First Floor:
Cost of Construction.$ 2 kb T Utilities:- _Sewer. _Septic- Building-Height-
CONTRACTOR:
Name Name: Larwe-a
Address ` )c lU(� �ir� cdpP. Company: v�nc�1C�1"illl ��r.ro Sync¢ C c�r�P
City: -:Fb r+ 1?WA 'O, State:-1_l_ Address: 3 60I 5 E'L�s Crt
Zip Code: �J�('�)l�� Fax: City: Stater
Phone No. 7.G (a B23 Zip Carle: 3�•�t�-►y Fax:
E-Mail-- Phone No :4--2
Fill in fee simple Title Holder on next page(if rdiffaerenf E-Mail . J-1)n wc�tLon A� h Cu I u,)en
.from.the Owner listed above) State or county Licer e of
If valid of consfniction is.2500 dr cii a RECORDED Ndtice of Commencement is requited. ,
If value,of HAVC'is$7,500 or,snore,a RECORDED Notice of Commencement is required.,
SUPPLEMENTAL,CO.NSs UCTION-LIEN LAllil:INFORMATION:
DESIGNER/ENGINEER:: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: -State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING.COMPANY: Not Applicable
Name: Name:
Addressi.: Add
City:
Zip: -Phone: Zip: -Phone:
OIAiNER/CONTRACTOR AFFi64 Application is hereby made to ob6m a pemnit to'do the work and installation as indicated.
1.certify that no-work or installation.has ca nmenced.prior to theissuance.of a,permit.
St.Lucie Cour►tyrriakes no represerrtation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws_or an covenants that may restrict,or prohibit such
stf dcture.Please consult Wth your Horrie'OWners Association and'review your deed-for any restrictions which mayapply.
-Inconsideration,,of the granting:ofthis•requested permit,Ido-herebyagreethat•iwifl,-in allrespei;U performthe:work
.in accordance with the approved 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,
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property.A.Notice,of Commencement must be recorded"in the public records of.St.
Lucie County and posted on the jobsite before the first inspection.If you intend to obtain financing,,consult
with 1LMder- n attome before commencing work or recordih Our Notice of:Commeneerr'ient.
Signature Own r/Lessee/Contractor as Agent for Owner SignZUCOF
of Contractor/License Holder
STATE F FLORf A STA FLORIDA
couNnrLo
of
°
Sworn to;(or affirmed)and subscnbed,before me cif Swor o{or affirmed)_and subscribed before me of C
Physical Presence or '"Online Notarization P ical Pree °e or Online Notarization, w a
this\b .dayof $f 2U2d by this day of 2U,t�by z X
O °
Name of persakirig statement. Name of person making statement, ,;LL.N
on,m
Personally Known OR Produced Identification Personally Known OR Produced Identification ° r
Type of Identifiron Type of Identificatipn— C, }
Produced__..._ o, L_.,, �._h.:__ _ Produced-
_�
.a
�Z C
(Signature of Nota ublic S Ea[ida) DEA `J
e .
Notary Public
State of Flo 4S nature of N Public State of Florida}
ommission H /
H 0863
Commission No. �� d* � omm.Expires Jan 28, A mission No. `�l (Seal)
Bonded through National Notary A
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER,.. 'REVIEW- REVIEW REVIEW REVIEW/ : - REVIEW_ REVIEW...
DATE
RECEIVED
_DATE
COMPLETED
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