HomeMy WebLinkAboutScanALL APPLICABLE INFO MUST B
. Z% ) 2.a- - E COMPLET
Datei
ED FOR APPLICATION TO BE ACCEPTED
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Permit Number:
Planning and Development Services
Bui�ding
Permit Applicati
on
ouuang and Code Regulation Division
2300 Virg,,
nia A venue, Fort Pierce FL 24982
Phone: (772) 462-1553 Fax: (772) 462-.1578 Commercial
C 0 n A I _�T' 7. 7�_�
Address:
Le al Descripti
Property Ta'_x0'1D #: � TLq
Site Plan Name:
Project Name. -
Setbacks front
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION
iditionawor T'a
1:HVAC _two
INFORM:ATIONG
10-M
e e orlow - me un er t is permit -- c 5�ca
Gas lank DGas Piping
Plum
bin []Sprinklers
Total Sq. Ft of Construction;
Cost of Construction: $
OWNER/LESSEE&
C�
apply;
Shutters
Generator
Residential
Lot No.
Block No,
CC�•r�
windows/Doors
Rood
S . Ft. of First Floor:
Utilities: Ll� Sewer � Septic Building Height,,..._
Name
x-
Addre
City:
Zip Code:".-ZFax:
Phone N ell
E-Maild
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:.:��( ^�
Company: 0, .;
Address:'
City'
Zip Code'!�J �}
Phone No,�'I_-• C !=
E-Mail*
State or County License
If value of construction is $2500 or more, a RECORDED Notice of COMMencement'is required.
State.ofa
Fax*
4PF
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIOU-6
s
DESIGNER/ENGINEER:--- --- ---
Nam.0e.,
Address:.
city:
State*
Zip: Phone
Rrnpya�i�.rr- _ _
FEE SIMPLE T7LE HOLDERI, _Not Applicable
Name:
Address:
Cityv---
z1ope Phone:
MORTGAGE COMPANY.9
Not Applicable
Name:
Address:
City: State;
Zip: Phone:
13UND1111114G CUVAPAf� V110
_Not Applicable
Name,,.6
Address*
City:
fti
Zip: Phone:
OWNER/ CONTRACTOR A.FFIDVITOO Application is hereby made to obtain a permit to do the wont and installation as indicated.
certify that no work or installation has commenced prior to the issuance of a permit.
St, Lucie Countv makes no representation that is granting a hermit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or such
structure. Please consult with your Homy Owners Association and review your deed for any restrictEons which may approh"Wt
ly.
In consideration of the granting of this requested permit, ( do hereby agree that 1 will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and Si. 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 accessary uses to another non-residential use
"WARNING TO OWNER: YGUR RFAULURE UQ RECORID A NOWCE OF COMMENCIMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS lid YOUR G�[R;(�fP�f�ITSf, !\ 6'S�'Pp(�� OF COMMENCEMENT MUST BE RECORDED AND
P95TED ON TM R_- J019 50TE BEFORE UHE RR57 9WZ[PECugGwv �fF VOU BNTEND 70 OE7ADRI FINANCING1 CONSULT
WITE 'YOUR PADER OR A'M TTORNEY BEFLORE RECORDONG WOUR WOVOCE OF COMMEMCEMEN.7-Nor .1
"
Sid of Owner
STATE OF FLO
COUNTY OV.: 10
essee/Contractor as Agent for Owner
Sf9d'a't_u_r_"'eof Contractor/License Holder
A STAT E OF FLOR
A-ic COUNTY OF
The o�ng instr ent as acknowledged efore me The f "ng ir�str/
this ay of 20 2 by this ay of Y
Name of person main staterria"t:
Personally Known W. __ Loo� OR produced Identifl"cation
Type of Identification
Produced
ley
%%WP l I rEM4%0%A 1160 W 6 l V W 4oI YVU i,111
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev. 27773�5
FRONT
COUNTER
(seal)
ZONING
REVIEW
SUPERVISOR
REVIEW
fi w s acknowledRed before me
IL 2 by
Name of pet -son mak ng statement, r
Personally Known OR Produced Identification
Type of Identification
Produced
NWie mcm
91A, 0.",/ IIAPjL%� P 4A A.01%
In
NEgnature of Notary Public- State
Commission No. q-Q4-S' (SealVft
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
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"'You'll Know The Price .... Before We Start" OflA
ELECTRICAL RISER PLAN
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Residential
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Underground
Service Size
Conductor Size
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Meter 1D#
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MeteF-Ga .
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NOT TO SCALE
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Power Kill Needed
Meter Pull
Cut at Weatherhead
Cut At Transformer
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408 Farmers Market Road • Fort Pierce, Florida 34982
Martin. St. Lucie Indian River Fax
772-283-7529 772-878-3974 772-231-1866 772-468-8924
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