HomeMy WebLinkAboutPERMIT 1605 BARTOW STAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
't- LuaL
—"e f '.«
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential X
PERMIT APPLICATION FOR: �1� _�Q A sA, IQ - —�
PROPOSED IMPROVEMENT LOCATION:
Address: c
Property Tax IDq: 3tiod - C,In- 0ALot No. 19
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Ieac- n�.t ex clir.n r el o..ci it�<�wll . Its
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical
_ Electric
Gas Tank
_ Plumbing
Total Sq. Ft of Construction: 1 6
Cost of Construction: $ f, f 50O
Gas Piping
_ Sprinklers
_Shutters _Windows/Doors Pond
Generator X Roof .S/d Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name / l
Name: an O
i�
Address: 160S 1�dri0✓ Sf•
Company: r q t OO�jn
City: _or-•'PjQCLe, State:
Zip Code: 349�a Fax:
Phone No. • d 16 _ i�l�.�Ic�
Address: �
City:`7�c� S}- Lvcla State: `r c
Zip Code: 3y GAC) Fax:
Phone No -1-1�» 23t 10 - a9'i C 0
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If Value of conaruninn is 7CM1 nr .n. a ecrrmner...—.—
E-Mail
State or County License C'CC 1310 %S-A
.............. ....c....c..mn. n regmrea.
If value of HAVC Is $7,500 or more, a RECORDED Notice of Commencement is required.
4
DESIGNER ENGINEER: ` Not Applicable MORTGAGE COMPANY: NotApplicable
_
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Nat Applicable
BONDING COMPANY: Applicable
Name:
_Not
Name:
Address:
Address.
City:
City:
Zip: Phone:
Zip: Phone:
)
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that noworkor installation has commenced prior to the issuance of a permit.
St.willpermit
is inaonFlict with anyeappllcabae Hothat
e Ownrers Associations permit
ovenants holder
aby tt build
aws or and prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the 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 pay.
improvements to your property. A Notice of Commencement must be recorded in t u Ic ds of St.
Lucie County and posted on the job a the first inspection. If you intend too in Tina consult
with lender or an attorney bef0 me work or recording our Notice of Cc e
signature of -Ow er/ s Contractor as or Ow r Signature of-Cont actor , cen Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF LJcnf
- COUNTY OF S ti
Sworn to (or affirmed) and subscribed befo Sworn to (or affirmed) and subscribed b o
Physical Presence Online No
, or _ r j6 p x Physical PresenP�ce or Online o
day S
this of V..JC . 2020 4 1 this I day of 310%Z 2 0 $
P c- on l o
j Name of person making statement T Name of person making statement.
Personally Known Y, OR Produced de fi Personally Known �_ OR Produced 1 n cation
Type of identification Type of Identification
Produced Produced
Virg• C. �� Vim- a . I
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of -Florida )
Commission No. 45
7r/ Qy (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING i SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.