HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE
Date: I �)
NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Planning and Development Services
Permit Number,,,,
Building Permit Application
'I.,
8 t
Building- and Code Regulation Division Commercial Z.. C3 �:; H 1G, _
2300 Virgin-ia Avenue, Fort Pierce FL 34982
Phone,: (772) 462-1553 Fax: (772) 4bZ-1516
Address. t.
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Property"lax I 111
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New Electrical Meter
Second Electrical Meter -
Additional work to be performed under this permit — check all that apply:
_Mechanical � Gas Tank _Gas Piping _Shutters
Flortrit- Plumbing Sprinklers Generato
Affidavit required)
Windows/Doors
r Roof
Pond
Pitch
Sql Ft., of
f Construction:
First Floor:
}Sewer S t" 51.��I eigi
Cost of Construction:�60 11 �
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Namelnow
Name LA L.-L,
Address:
City:
Zip Code
Phone No.
Fax:
\(l"T -)lvi
State: L•
E ftVA I -
dill in fee simple Title Holder on next page (if different
from the Owner listed above)
If value of
If value of
constructi
HAVC is $7,500 or more, a RECORDED Notice ot Commencement is required.
Company:
Address:
City:
Zip Code:
Phone No
E-Ilail
Fax:
State cr County License,,,,,,.i=.- L.I J,,�UUI
on is 2500 or
more a RECORDED Notice of Commencement is required.
low
State: "FL
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DESIGNER/ENGINEER:
tiF �•• - + - y- F •• s f _• i t
Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: --..
Phone,.•
OWNER/ CONTRACTOR AFFIDVITO
_rat .v ;_ '. _ .. ,. •: ' ..•t�v '•�'x� � ,•. r..ti 1`•'{i' t.• •dry .�V •.��,
. .�.� ,. r. •; .F - .y M1 �.. .''- :•.�':f P.t'y:. v* •- y-•C .;•�.�.., r},A•, � �••M1 •�_ __!•� .:+';,�, }• T M1"r�2�x"- � ¢' ..i� '•t �:• j}'1
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MORTGAGE COMPANY0 WEEEENNNNNPV�
NotAppf*lcable
Name:
Address:
City: State:
zip; Phone:
BONDING COMPANYS
.Not r�ppliCablr
Namet Address.. city:-
Zip: Phone:
Application,is hereby made to obtain a permit t
o do the work and installation as indicated.
certify that no work or installation has commenced prior to the issuance ot a permit.
St: Lucie Countct structure
y.makes no representation thatis granting a permit will authorize�ic the �pe�mPnholder a� build
restrict
orohibit such
which is in contUct witn any appncaoie n�ulne vw��cI� ru�V�1p��v�� I u���, �y:ur�
_._.._�.._.. 1. ,.,:«ti .,,,,,,- u,,..,o n,A,.,Prc Arzcznrintinn and review your deed for anv restrictions which may apply.
if Ul.lu1 C. r�eaac
�.v�iaui�.v�u�
y..__r.�_
___�.___..,...,,..�„a ...,..,.,"* i a., korokv naroothat
I will in all respects.
perform
the
work
in C01'151QerBLIOf1 OT Lrl@ grarvorig, Vi u"o icyuc�Lc�.+ Ncitiny � u�, ���....,.�---
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt Trom unaergoing a Tu11 LU���U I IC��ty I CV =Y�. I VV t I I Qw��������,
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 paying twice for
im
nrnvpmpnt.& to vour oroloertv, A Notice of Commencement must be recorded in the public reco
rds of St. !'
rt�� �M�I rr,ctcrl nn thP inhr,'tp hpfnrp the first insoection. If you inienci to obtain tinancing, consuiT �+
t� l�
Lu�FV.vuly a�n� Vva�...ni. ,
with lender or an attorney before commencing work or recording your Notice uf Cornmencemen
r
Signature o
per/ Lessee/Contractor as Agent for Owner
STAII OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and s
this i +�21ay of - .. NJLIL
ubscrihed before me of
Name of person making sta.ement.
Zaby
Personally Known V OR Produced Identification
Type of Identification Produced
(Signature Notary Public- State of Florid )
commiss,10n tip. GG �q (Seal)
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev 5/ zu/ iz I
FRONT
COUNTER
ZONING
REVIEW
a
Physkal Presence o
r Online Notarization
'� ,y" Notary PuNic State of Florida
MargairrOEeMOnteVare
My Commission GG 214W,
Expires OV05/2022
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
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