HomeMy WebLinkAboutBuilding Permit App Clarke1 All APPLICABLE I NFO M U!i T BE COM P LFLED FOR APPLICATI U N TO BE ACCEPTED
Date: Permit N_inibe,
Building Permit Application
Aarrnfrg and D-a elopmerif Ser CC 15
Build;nfl and Cads Aegufatron Division Commercial Resident 12a I
2306 Orpma Avenue, Fort Pierce Ft 34
Phone; �7721 462-1553 ray, (7721) .2-1578
PERM IT AP PH CATkO N FOR; i
PRO POS ED I M P ROVE I!NT LOCAT!*-
Ad(]reF�5- 0311
t
Property Tax I � " ` _ Lot NG.
Site Plan Dame; :8ioek No-
Project Name: ---
1..DETAILED DESCRIPTION OF WORK:
_ � ,
NE-w Electrical p.+F .t*r Secor.d Electri mr Mete:
CONS]RU&I€ N INFOIRMAT7CIN: M
add itiortal work to be performed under this perm it-dheek all that a 4y;
' _Meaani c81 —Gas Tank _Gas PI Ping _Shutters _ Win-d4;-v:s f Door6 _ RO'1d
Electric _Mumbing —Spri n klers _Genera#vr R.rfi Pi.
-'otal Sq_'FL of Construetion, Sq. Ft,of Pint Fleur:
Cost of Cortistruttion, UtilitEe5; Sewer 5epti{ Build iog H-6ght=
.OWN ER f LESSEE= CON ACTOR-.
_
ity_ t'� ,, stage: Address:
Z11)Cade_ fax' City{ . .-L. + S �
PhurtiL-Nu_ - _
-3 1. ip cide: mac:
E-Maii: A jL t '3 12e_U Sdw . jrk-�-j Phone Nci
Fill in five$irnple Tit6-Holder on next page if dMerent E-Mail I AOL jP h ,.M I"P ' _ .4Q..
#turn the Owner I isted above) Mate or Courtt� Lice nseL� ,
of v31ue of construction is 2500 or mDre,a REMMED flotiae of Cumm%encement 4 rcquir4�d. _ -If value of HAVC IS 57r500 ar more,a RECORDED No-tice of Commencernent is required,
SUPPLEM ENTAL CONSTRUCTION LI EN LAW INfOR A- 0N=
�-
DE�I�NEd/EN61Pd EER: _P,4ot Appl i cable MORTGAGE COMPANY, � Flit Applicable
Marne, i+laMe:
Address,: Address;
Clittit= State' City{: State;
Zip; Plhane Zip,. Phone:
FEE SIMPLE TITLE 14OLDER: _Not Applicable BOND ING COMPANY, Not Appl icabJe
N a m�= Name, _
Address: ,address: _
City: faw
lip: , Phone- ZFP: Phone:
OINN ERf CONTRACTOR AFFIDVIT:Application Is hereby mi du%Lo obtain a permit to c5o th-P work arld instaf lation as indica4ed,
I cmf4 thin no wor k or i nstailatim has commenced prlvr to the issy-nce of a permit.
St. Lucie County makes no representaticn that is Vanti rt�,a pC fmit w11i afftt<uIUL theEr
rrnit Raolder to build the subject svra[#uf-e
which-15 in cznflict wEtfn arn{app6oabl Home a rn Assotist�or�rules, trfLaws ar arenar tf�iat rnayr r skxi C or pcofndait suxJ r
�tnt,Wre.Please onnsuIt with your Home Gwrwr::Aesociation and reuiew your deed r #rict6oe�s w�ioh essay apply,
In cow1dieration of tle gr-anting-o€ttiis request-Ed permit I do hercb 09-Pe tl�=I will, in all respeca, prom the work
in accordance with the approvvd Pl;w�,the Klorida 1341ding-Codes and S� Luciei�Durrtyr Amendment;.
TPke follomng bwlding permit applications ar a exempt from undergoi ng a full conmTrercr rev9ew:room additions,
accessory strmlueM wAffmming pails,fencm,walk signs}scram rooms and accessory uses to arLotNer non-re.:Uentiai use
WARNMI-G TO I NESC: Your failure to Rewrd a NotTcr of comnwcement rpay ram## h paying iwiae for
i rn pr-averr ent5 to ,,Hour p r-D perry, A N ati ce of tom rinenc-etnent rn ust be reuuTded in the pu blic records of St_
Lucie CGUnty and posted on the jobsit-e before the fi rst i nsper-t ion. if you i ntend to obta i r3 fi nnin-ci n& consult
with lender or a rj a'Lt-ome commerrcing.vwork or recordl rtg you r N utiCe-of Corr m cement,
Signstur£-of Or+n&[tessee/Comactcx as Agent`nor Own-ur Signature cF entractor)License Ii der
STATE OF FLQRIDA STATE OF FLORIDA 4 �
COI. AITY OF � COUNTY OF � • �,
Sworn tk[or affirmcO,rid Wb!wrfbed before me of Sworn to[cc affirmedM and subscrf htd befnfe me of
ph sisal Presence or 04IFrne Notarr2atino eat Presence or Or}Ii nc N Wfu5um
this ,IV of gc ,2020 by Is ay of_
#Jams of;x-w 'm-,Wng statemsn`. Name of persDn making statemt•nt
P&";)I1+Knawn OR Pradu€-ed Idervt.oat m Pez 5onal;V K-.own n OR Fi oduoed Identification
Type of Identification Type14 - of Idt i f'i 7tion
dn P; u produced � —
",CA P
[Signature cif Notary uhliic• 5tas'c of NO a {Skgnature of NOttlry PUb1,r.-Stare of FI - - )
� } TAVPUWC NOTAgy P4JS�
CommissiontJ S-ATE0F FLORI rr ission Nol mr57 TAB ,�B
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REVIIENS FRONT DN I A SUPEFkVISDR PANS VE-G TATION SEA TU RTiE MANGROVE
CO U-NTER R1=VI EVV REVIEW R EVI EW R EVI EW RE 1EW REVIEW
DATE
RECEIVED
SATE
= CjQMI PIED
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