HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONA 11 APPLICAS LE J N FiO M LAST B E -1120 MP LETS b FOR APPLI CATJQ N To D E ACCEPTED
Date=
970
V
Planning and Develop merltserv;clll
Perril Dumber,
Building Permit Application
Building nad Code Regaiation oivi 'ion C01"E'Imercia I Residential
23W l +rgiab Avenue, fort pierce FL .3'49S2
Phone= (772} 4621-:1553 F-ax; (7-72) 462-1.57.8
PERMIT APPLICAT1CN FOR,
P1_61_0ED IMPROVEMENT LOCATION-.
Address: m -
Property Tax I D #: 49— 50-
Site Plan Name:
Broject Name= i
L
Lot No,
Block No.
DETAILED DESCRIPTION OF WORK, 5(_0 6
lllw k� L/"
Y
New Ele ricaI Meter
i�' j 1 � r v1t,n•
Second EletrcaM et r�V► 1
F�ONT1R L1CT1 OINFORMATION-.
Additlona1 work to be performed order this permit --check all that apply_
_Nedra il
EI ecri C
has R anic
, Plurnbi.ng
Total 59. Ft of Construction=
Co st of Con structi on = o ),
_(5as Piping
_sprinklers
Shutters , Winduwsf Doors Pond
_Generator Roof Pitch
Sty, Ft. of Fi rst Moor;
0tilitiill — Sewel- ` Septic Building sleight-
OWNERAE EE: - CONTRACTOR:
--�
Name F -
Nail r�
Address: c�
gjl r c''' . Corr, pa mi:
city -
State
State _ �- Add r-es:s:Jmp
Zip Code: Fa
city-
tat=
hne No zip Code; Fax: _
E-lail: } ' Phone No -14 1
Fill in flee simple Titfe Holder an next page H different E-Frail f� �
fru rn th a Owner liste d a bove ) in,
County Lloen sie �
If varue of construction is 2500 or more, a RECORDED NcCke of Commencem. ent i5 requiratl.
Jf va I Lte of H AVC is $7,500 cor more, a RECO13DE D Notice of Cori memement is req u irew,
I-
ION LIEN LAW jpjFOR
—TIlV: —
DESIGNER/EN f L R.- Nei`A I�
iMarne; rc�kfe
Address
State -
zip, — Phone — —
FEE itf RL�TITLE HOL-0ER:
Nams - z dot App1 icabJe
Address:
city:
Zip: Phone:
OWNER] fUT rLn
9 hint Apiirrakie
Name-,
Address-
city-
Zip: Phone:
AEFIvvi![ : Application is hereby mad ire rrrri the '
J �rtrf�+ that rro work or fnstafiation has carnrnenced J�ri�r tq the issuatO Obtain
a permit. a work and instaliatiori a� inda�at�d,
fit. Lug ie urn#� rr�alCes rr representation that is grantinga rmit v+r�l [ authorize the
rrrl it
W ieFr is i n conff is Mth rM �ppii a bl Fi m a awn ers 55oC1 holder to b �, iJ tructu re. P f ease c� u I �nr�t h yoor E�orrr w ri ati �n a n d review l ur leek farthat a su b r P 0hjstrbit su
i n r review
hyla ur Sri cove rants etio mwy ich r et or pr y, fit ��rcf�
Ir7 [ensfderation Of the granting of his requested perrnjt. I do Jere Y r�s�rftti�ns which may a�i�r.
i D accordance with the ai�Pro d P� ans, the Agri da B u i [ding Cod e 5 a n t. Luc a ulnx �n rn nd respects, Der f+�rrr� the work
Th e fof fauwrng b u I I ding perm rt applications are exempt fro rn and a reo i n� a full concrrrr ��rrrer�dn Eerrks.
accessory sl:ructuresr S+NIr'nn7ira �ralIs, sigr•rs, screer� rooms and a�c�ssOt+{ uses to alnntb� cyrevfew, room additions,
paoJ fencsr
W�kRNIN TO OWNER.- Your faikrre tO Hemrd a Notice of COMMeftemenit m side fotjar
I use
i m P rOve me nts to yo uir property. A Notice of Corn � ens rye nt M ust be recur � d ink' e twice fir
Lucie CcUatY and Posted on the jObsite before the fiat inspection. If ou irrt a �r� the r,� it r r s fit.
ith lend -or are ttr rrre before u rnrneraeirr irk r recordin oar Noticed to obtain financing, consult
of Commencement,
ig.nature of owner/ Lesse-8/CanTr-8-=r a
Agent fir Owner
STATE OF FLOR110A
COU NTY O
5�nr�rrk to (or aff i rmed) a n d subsc ri bed before rn e cf
-4��r}plI ical Presence or _ _ On i n e Rota n Zat i an
this "5 day of } 2021 by
Name Of person makJrlg statement,
Re rs-o n W ly Fin own _ OR Praduced I dentf fi ciati orr
Type of Identification
Produced
r
nature Of Hotary Public- State of Florida j
'dq
•W
REVIEWS FRW T ZONi xtug( u
i
COLJ NTER REViE R
DATA ��
RECEIVED �E01F
SATE
COMPLETED
eev � —
LV
MORTGAGE COMPANY." Name:.lVtlpiicabJe
City- �t-ate:
Zip: phone:
i
BONDING CoMpA N_ lr:
Signature C Curitrartcrf License Molder
STATE OF FLORIDA
COUNTY OF �
Sw n to (or affirmL-d) and subscribed before me of
bysical presence or Online Notarization
#his dui of 202-1 by
Vito 1; le .11 AA
Name of person making statemerrt.
persOrralfV Kno-wr-i _A�uR produced Identification
Type of Identification
Produced
(�rature of Notary pubic- stat�,�,�rid A15
fopH .6
OCO3 rn-r5saon No-
cza'6Z J!M*v Sea) � µ
•Zt4N3P
OP LAN 5 VEGETATION SEA TURTLE -k •y � �
REVIEW REViEW REVIEW Lr,�� iE
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