HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
�ermft Number:
Date: ,..�._� _
Building Permit Application
planning and Devetapment Setvfces
Building and Corfu Regulation t13vIsIOR
2300 VfrgfnTa Avenue, Fort pierce FL 34982
Phone: (772) 462-1553 fax; (772) 462-1578
PERMIT APPLICATION FOR:
Address;
Property Tax !D #:
Site Plan Larne:
Project Name:
New Electrica! Meter
Commeraocil Res'Wential
Second EieCCnC2�i Metef --- -
NEWMmeft
AddiInal work to be performed under this permit, -check ail share apply:
r ��a.-�,anirat Gas Tank �.GasPiping Shutters
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0WPMWftft*"�
Y lYiX-.; L+
Z/Electric Plumbing
Tnt�l Sd. Ft 0f ConStructoMe � $t{. Ft. 0f First Floor:
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4 11 Copt or Gonstrucnon: ? " & - WNEIP
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ZIP code!,
Fax
Phone No. �-
E-Mail*
title molder on next
frorn the owner listed above
utilitieso, WWF--WSewer septickv�
state*
if dtfferent
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Company,:,
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Lot No@
Block No.
S/Doors Panel
Qo.� Pitch
8uilding Height: -=am
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Phone
E-Mats
State c _ Or
if Vslue of lion Is 2500 or mores a RECORDED
it value of HAVC IS $7500 or Mom, a RECORDED NOATCe of Commencement IS required.
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'.�;�4./Yys�a'x"�t� �i#��"his•+�:;�rj,:�..+ti.,r:.�,'•';4.*�+.+4��w _ *'X Not Applicable MORTGA6E COMPANY&�
MKinHER/ENGINEER16 4WO-WROPAMM 1
Name:
Address:0M P m PF
City: Sate :
ZI P-80 Ponewaaftm"W
FEE SIMPLE TITLE HOLDER: ._ Not Applicable
Name:
Address. -
city;.
Zip: ?hone:
Address;
Ci
zip: Phone:
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f�•:;�.it �t.�"!�'•�
Not Applicable
BONDING COMPANY& _..10NotApPG�ca6fe
Name:
Address:
city:
Phone
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It CONTRACTOR �11l�FiDVIT'. Al�i���nr eat urn r to the Issuance Q�a permit.�perm
to �Q the vvo
Ck'!"��Y ��ldt 1iQ WOri(QC tf�sl.diinatvrc ��4? •••.••••••---._.,_ .-- - -
r riot or ol�tbit such
St. Lucie Coup makes no repres�ntaiionm� Oumers As �c�at���� eis by al ws or �n c4 enacts that r�i�ay t���t subjectstructure
which [s 1t� c���ict with �� ap��[ca�le �!o ��a�ivn a�c� revi�w�o�t� ��ed �r` any restrtctionswi�lch may apply
st�'�[ctur�. Tease cons�it vu�t1� your Nome Qw�ers Assa i� i �� hereby agree that I w�#lt in all resp�tst perform the mark
In cans]deration air the granii�tg of this requested permit,
lin accordance with the approved pians, the Florida Building fides and St Lucie Cou � � ��� e c Own ��itions,
�'ite follc�win�, building permit applications are exempt from undergoing a full concur�t
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accessory struct�tres� sw�t�t�nin� p�is. fences, wails, signs, act rt roes and �cca��rY uses to ar�flt�er �or�-�'� ��e for
ial
WARNING TO OWNER's Your failure to Record a Notice of CornMencemQntbe recorded result ipaying
n �p�b�ic re�t�rds of S�.
improvements to yo��' �'aR�rt1�. � ��fi�� of �vrnt�encen�er�t
� s � �=Ommenelngsite �e�vre the first inspe��Qn. l�you �n�end tv��nenCe engt���sutt
LU��e �vun�,.� d'����c ar r��orc�in�Udtel*fttO
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with lendef �e� e � .r-A '%law►
gnature
STATE OF FLORIDA
COUNTY OF.....
ee ontractor as Agent for Oec
rn to (or affirmed) 1ar1d subscribed before nne of
physical presence or QnlIne Notartzatidn
Ufa of M�T"
20�t by
this 7::>wiw4y-1
Name of person making statement.
Personally Known ) OR Produced IdentificatI011
Type of Iil
Produ
,� �•,+ 11. tic - State ! ' ',orica
,,. to
(Signature 0 -�ir 'ar
Commission OIL xotari
REVIEWS
DATA
RECEIVED
DATE
COMPLETED
,ev.yb/�
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
tlgn;aturetw-f�se Holder
STATE OF FLORIDA)GOUNTY DP�=4�-III
—�-
Sworn to (or affirmed) end suhscdbed biefare me Of
Physical Presence or . {3n#ine Notarization
this Jl...,. dale of
Marne Of Person making statement.
Personalty Known . ,_ 0R produced 1der�tEi�catton
Type of 1det�tificaiitrt�
Produced-
(Signature of Notary PILL%,
�c�tate'
commission Nc�. �ZIl
PLANS
REVIEW
VEGETATION
REVIEW
Cc)mrnission
hky COMM. ire
OF
a
(S�Aed through Nat'O'
SEA TURTLE
REVIEW
MANGROVE
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