HomeMy WebLinkAboutEaton AppII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date;; Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
.2300. Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-A1553 Fax: (772) 452-1578 Commercial Residential
PERMIT TYPE:
Address: Aa(gma r� 5ar(
Propq, Tax ID #: �3o1' GI1-1� °t °
Site Plan Name: FG q Block No.
Project Name: _
Additional work to be performed under this permit --check all that apply:
Mechanical Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing Sprinklers Generator
Tote#'-Sq. F' o� ConsrWztlon: _ Sq. Ft. of First Floor:
Cost'of Construction:FJ - f?n _ Utilities: —Sewer _Septic
state:n%
Zip, Cade: a .1?2.,�___ Fax:
Phone No. a 16(Q- �5$5
l:-I`+�o a i L
Fill;'in fee simple Title Holder on next page { if different
from the Owner listed above)
yWindows/Doors
Roof Pitch
Building Height:
Name:
Company: t�Alil� _ FfrlQr %f— 5rCAA W Cf�S VA,.
Address: JO..[3 D"'
City: Stater
Zip Code: 3a9'61 Fax: 3X-?- -4-3f__
Phone No -7 a-33'7— A4110 --
E-Mail �.lA [.S_(1u
State or County License_ CY151?
t
if vai'ue of construction is $2500 or more, a RECORDED Notice of Commencement is required.
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Not App
Narhe;
Addr'eas:
city?"", State:
Zip: _...-... , __._ Phone
---
FEE . MPLE TITLE HOLDER: Not Applicable
Address:
City:`
Zip: .
Z � Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip.. -.-- Phone:
BONDING COMPANY:
Name:
Address;
City:
Zip: Phone:
_ Not Applicable
)UWN.FR/ CONTRACTOR AFFIDVIT. Application is hereby made to obtain a permit to do the work and installation as`indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
it. Lucls_ CoL rmv rnak4.� no, 4)r esentation that is granting a permit vain auihoriie the permit holder to build the subject structure
vl•iich i , sn conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
tructtire. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.... .
n consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
n acc8� dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
-he foi'building permit applications are exempt from undergoing a full concurrency review: room additions,
cces..'yr strucr.��re s, sw:rnrning pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use !
WAI2RIIING 1-0 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE IFOP EMPIROVEMENTS TO YOUR PROPERTY. A WOTSS:E OF COMMENCEMENT MUST BE RECORDED AND
P(3$TED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
i'YANH YOLK LENDER OR AN AYTORNIEY BEFORE RECORDING YOUR NOTICE OF COMMENCEWNT_"
5igrr�j:frura of pwner/ Lessee/Contractor as Agent for Owner
Signature of Can rector Lscense Holder .
i"A�rE JF li:G.Oi~tu6:,�
� STATL OF FLORID -.
The F`" oing ac:knowiecay-1+ L;efure me
lilt: for wing iristru ene was acknowledged before me
�.. '�/
this clay of _ 20 by
this day of 20by
Name o pet rson rn,aking , •
tdtEment.
��.✓I
� Name of o€ erson making statement,
ixar.cci} )Iiv Known OR Produced Identification
_
Personally Known _— OR Produced Identification
T 6(Ident,ficatir ~
, Type of identification
Preducf:d
I Produced
( ign tore of Lary Public t e o lorida ;
i (ignature otary Public- State of Florida )
Cornr�isslun No. _-__— — -- (Seal)
� Commission No, ( py1a
`
�S
�4►�V R3f6A lVa ry Puol)�. Stateoff'id 16
Asfrrey M Anronmlfi
REViEWS FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
*'has add f x
S
iral 1ts/tS12i771
i' COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE'
RE.CL,VED
—
DATE,
-