HomeMy WebLinkAboutapplicationAll AP4>LIC4 ALE INFO MUST BE COMPLETED FOR APPEIC'ATION To BE ACCEBTED
D k'; - f : •j- -� I Ferrrtrt N uJ nber:
I.:. I. I, ;;. Building PermtApplicatian
ArGnni ay and Devekpment Sww,'c es
Bug&ng andCc6e Rrgmfvtn Dy sicrr carnmerclaI Resldenttal
2.OIO Wrgrrm Awmew, # Pfrrcc FL 349&2 —
Mont- (1172� -=3 Fax: Jam) 2-3578
PERMIT APPLICATION FOR:
PROPENE D IMPROVEMENT LOCATION;
Property Tax I D #= 34 L>;L, — n 6 — o L)o - LW No, f 1 � t
Site Plan Name: ejock NCI,. N
Project Name:
ETAI LED DESCRI PT10N OF WORK'
.�66 K eti-
• GF- C f tit -,CA S CLY• ,
New Eledri{al Meter Second Electrical f mr—
CO TRUCE1 +1 I NFURMAT ON:
Additional work Lo be perforri f'd ti ndt'r thi � pt rmit check all that apply:
Mecharli�-,al
lectric
Gas Tank
Plumbing
Total 5q_ Ft c f Conste6c#ii?n;
Cbst of Construction_
-ONE G
CL
_ Ciao Pi ping
5prirtklers
Address;
City: _._fry &e :!$e;
Zip Ctdde- `fj Z5a Fax: IA .
Phone NfX. -
E-Wbil:
_ sllutwm Windows/Door.. Pond
Generator _ Roof Pi#cf`
$Q. fit, of First door_
Utilities. _ Sewer _ Septic Burl<fing Heig v
Fill in fee SiMple Title Holder on neA paw ( iif diiffeeem
#rom IM Owrvar listed above)
CON TRACTOR:
Name-
Company:— WAAC -ar\-0
zp tee: - _ Fax:
Mom No
State or Couffty Urense
T�
if vogue of wnsxruction is 25W crr more, & RIECDRpED Nvtke of Corrrreaerr Dament Is rrWk-q,-d,
If vDkeaf HAVC 4 7, or mor% a RECOFLOED Nw4ce *1 Commeixtrnew j:j FaWked_
SUPPLE M EINITAL CONSTRUCTION LIEIN LAW INFORMATION=
Not Appiica bl e
Kame:
alyY Stag:
Zip:.. Phone
POE SOPLE TITLE HOLDER. _ Not ApplRcable
Nance:
A dms:
y: --
Zip= Phone:
MORTGAGE COMPANY:
_ Not A ppl ica ble
Na me:
Cityr:
-
Zip'. Phone:
BOND ING COMPANY:
Not Applicable
Name:
Andre!;
Cam:
i phone_
--
OWNER/ CONTRAICTCR AFT-IDVI F: Appiication is hereby made to obtain a peTmit W do the work and instaLlation as indicate;.
I certifV that no %cork flr rn0 allutuon ha! CQCQMM d pftr to 11m iy uancc of a perm it.
St. [ acme County mukt1s n0 r#�pr(-ia•rit;ptj*n thy# i.' rrinUnp -;� pumat will authorize tht perm is h6der to build the sublet struuiune
xwh ich is i n ccm iCt v ith any applicable !fame Cu ers Assodati,on rules, fw las or a nd covenants that mwy restrict or pr-ohibit such
structure. Please wnsuIt w I h your � am*- 0Ywmers ,4�5 )ni$ rtwier your d� a far aayr Iegric i0rI.S WN h m4vv applyg
In Wff�d+brabun of Wc pran tin -�- Qf Zhis icQucstcd permit, I do hereby agree that i wgf, in all respects perform the work
in accordance with the approved plans, the Florida Building Codes and St Curie County Arr endm-ents.
The fallowing bugdfing permit: applications are ext-mpi from undE-rgaing 41 full. r�oncurr"cV review: rabrrn ;)(idiraGny,
A Sl rMe-WrM !�y iMmirjg pooh, Fences, walls, -signs, screen roams and accessorw uses to anGthe r nonresidential use
WARN ING TO OVV ER. YMA faZture t-n ReQord a Noce of Comm ,encement may result in payiirkg twice for
i rn provernertts to you r prgpertV. A Notice of Corn mencernent must be records d i rs the p ubl is raccids of SE_
Lucie County a nd posted on the jobsit,e befo re the fi rst i nspection. If Vou i me nd to -obtain fir1a nciing, consu It
with liende r or arc att�ney> #qT c r??n}enci ng work or record iT g you r N of ice of Comme rree me nt.
Sigrra#�"r as Agent far der 5i o
STATIC OF RMDA ST#TIE OF FLORMA
UNTYF'y`� .' . ,,..� COUNTY OF
Sww far affirmed) and subxnbed hire me i)f
_ phwkal PteSTCe or Online Rutar3zation
khi5 lda r ¢f �' 2021 by
Homer
c L_,,. c :- ,,!
5woi1or afllirmed.l and su bscri bed b�efine Fn a of
c �rPhymcal ftaaserw-e of Online Notarim i,6r<
Ar
Name vF person making smbement 'Name of person making statement.
PerwriaNyr Known OR Prod ucevVee
Type of Mentirfication
FT duced
f LT
µ �Z
{Stn*Lu vF Notarj_NLOkState of Ftori
Vt
REViE WS F RONT Z014I NG
Wt_RV�
COUNTER RFFVIFW
L1AT E
RECEFVED
DATE
PersonalEyr Known `� OR Produced Ldentifi
1 ype o entifiieation
Prod
(Signature Notary Puh1FL- $twW of F4cM;k 1i
Carnmission ND. (� C �� � � � �SeaL�
EL g ':E
PLANS I VEGETATION SEA TURTLE MA
REVIEW f REVrEW REWE Yif RRIE