HomeMy WebLinkAboutAbrams_ AC Permit ApplicationAll APPLICABL INf0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: c1 0 tq ( Permit Number:
-
P c C-1; > : c c, i% - Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial ✓ Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: --7
Address: 96W Y OL�QCtYI l-f� G�l1� /�1� �J E'/ISC'� 1&a(6 53 1'IT 7
Property Tax ID#: -4 0,c 2 -613,,2 - abo - 5
Site Plan Name: /�(I
Project Name: AJ
DETAILED DESCRIPTION OF WORK:
1
Lot No._
Block No.
,, -
Y A—f r icy
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Windows/Doors _ Pond
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer —Septic
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ' S
Address:
City: �Jln'uri �� State: �
Zip Code: �04'-7 Fax:
C.� �/
Phone No. �( 5�!- �5 ' -( 7 3 E-
Name:
Company:
Address: d
City: (
Zip Code:
vhone No
v" State:
3< <CFax: 77_T -,_�,(, 412 1Dq-11"
�7-r7 -" �G�U
iviaii:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mailo l-eo �� G%j
ar r�iyw -n
, c6
If
State or County License C�
- �J� �'7 %
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DES#GKEf l #NIcM. Not Applicable
Name:
Address: _.
City: State: _,-
zip: Phone_—_
FEE SIMPLE TITLE HOLDER: — t4pt Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Name: -
Address: _
City: — State:
Zip: Phone:
SONDING.r"DWANY; Not Applicable
Name:
Address. —
City: --
Zip: ; Pilule:
OWNER/ CONTRACTOR A ItT: Af OtWort is -hereby made to obtain a permit tra do the work and installation as indicated,
t-certify that no work or installation has commented prior to the issuance of a permit.
St_ Lucie County makes ma mpresentation that is gi ntirga hermit will authorize the permit holder to build the Subject Structure
which is in confliictyvittl arty applicable He7w uwr ers .F.-octation rules, bylaws or and covenants -that may restrict or prohibit such
structure_ Please consultwsth your Home Owners Assoclation and review your deed for any restrictions which may apply.
Inconsideration of the granting of this requested perms I do hereby agree that I will; in all respects, perform the work
in accordance with the approved plans, the Florida 8,jiiding Codes and St. Lucie county Amendments.
The following Wilding permit applicaftonsarevywqrpt tram Undergoing a full concur.rency review: room additions,
accessory structures, swimming poiNs, ferveK wi ts, sites, screen roams and access"usesto another non-residential use
"WAiZRMM To OWN= YOM F .TsI'iR FA[OM A NOTJM OF COMONCEPEWT MAY RESMT IN YOUR PAYNYG
FOR 10POWWWOMMIS TO 'ram RRKVMWTT. A 1119E OF MUST BE RECORDED AND
POSTED ON THE .toe Si'fE 8 . FIRST �i11.
W YOU MW TO OBTAMf �, CONSULT
'J
`MH YOUR: LOOM AN A� OEM R1It[RONG
T6l1)!€ M0710E OF
.OR
Signature of Owner/ Lessee%Contradoras i 'fur J"V er
signature Of (Z.W.Lractar/Licanse Holder
I
i STATE tf FLORIDA 't %
STATE OF FLOR t?A `
fOUOti'Y CIF_._.
COUNTY OF l-�l-�+:-���......__
L
The foring instrume L was acknowlefte-1 re me
this day of ?!} tzy
The. f t ng ins. mm _ was cknowiedge�d� -fore me
this day of _ji— , 2� r by
Kt [VI ISOnin �_:
—M LU I
Name of person making statement.
Name of person making statement.
Personally Known ✓ OR Produced identification
Type of Idenf#ftcation
Produced
(Signaturl of Notary PX17 State of l:
Commission WMA, m
REVIEWS x :xVISOR
COUN MR REVIEW RE''<!!EW
DATE _._.
RECEIVED
DATE
COMPLETED
Personally Known s/— OR. Produced Identification
Type of I&ntifiratior�
Produced—
stateof
Commission I P.
6*SApr3lt7,�2'1:
PLANS. I V - GROVE
RM:-- tf REVIE"Af REVIEW REVIEW