HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE .INFO MUST BE COMPLETED FOR APPLICATION TO. BE ACCEPTED
Date:
COUNTS
A, Permit Number:
Building Permit Application
Building and Code Regulation Division Commercial Residential r/'
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)'462-1578
PERMIT APPLICATION FOR:
Address:
Sa9CL
Property Tax ID#: ;%a j !SrO % Oo Sa Gov 9
Lot No.
Site Plan Name: _M-ttvfl Ic (2 c.S�eQ 2K c-t
Block No.
Project Name: _ liY1 c L
d-,,, c -e-
New electrical Meter' Second Electrical Meter_
Additional workto;be performed under.;this permit check all that apply:
.L
' C--Mechanical,._ Gas Tank _ Gas Piping _ Shutters _Windows/boors ' _pond
---Electric �
Plumbin Pnnklers j.. ; > fti``"
g S
—Generator Roof _�'/"I'Z 'Pitch' ��
Total Sq. Ft of Construction: bl 9
Sq. Ft. of First. Floor;
Cost of Construction: $ �-�� 3
��_ Utilities: _Sewer peptic Building Height:
%`air=��iii��Y���,.'._��`>�,r.:•x......_..._.,_.,.,...,.,_..,,.,.,.,............._..---. _._. ,. —�—
Name r; K ",1; 4- MV)e.Lk,
Address:_530H S-Iqj
City: t I`
State: ,67L
Zip Code: -3 I 7 %1 fax:
Phone No._" 7771 3-'q ,:6
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from -the Owner listed above)
iAL
Address:-2-Ub Lobe
City: State:
Zip Code: Fax: 172Lf6,�-7$13
Phone No 772- 12,bi — 7-7 9-7
E-Mail C>�i YavlCc�»S�}-p»cAn abl" e6M.
State or County License ;�q d) 36X I
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.
Name: `
Company:-Di-Franer'Sea e,��rCAVV
NERIENGINEM'
cab
Name:
Address: State:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER: LPFIR: Not Applicable
Name:
Address:
City:
71 Phone:
MORTGAGE! COMPANY: Not APPlitabte
Name:
7— Address-
,7Si
at-
e:%,..2
City:
lip: Phone
BONDING COMPANY: "Not Appficable
Name:
Address:
City:
Zip: --- Phone:
0 NER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
permi, t -
s
Hnst Ilation, has commenced. rior,, jS
I"certify that no work o a p I . d
heggtrnit', o e-�tob'uild'th'esLj6ject,sructure
e �tiT�n.�6�'�i�!gta,ntinga�pert;hiiwiiiauthoritet 'may ict-orprohibit.suc))
St. Lucie makes no represent ulesbylaws;oran covenants that, restr
cie Coun applical?le;H6inb owners- Assoclatim r a.nY restrictions'Whi& may apply.
which conflict with an�
OW60ts,tASsotIjfjo' and review your deed1or
struEiiTr6-.'�i-e-as6lc.onsultWith.'ydurH m Will, in all -respects, perform the Work.
e granting of this reqUested. permit,hereby a'gree that I
In considerationofth . County Amendments.
accordance with,the approved plans, the'Horida guilding Codes and St
in. acc. additions,
roorn
pt from undergoing a full concurrency review�
The following buildingrpermit-applications are exem - to another nonresidential use
11s, signs, screen rooms and accessory uses
mming pools,lences, wa
accessory structures, swi I n ng..twice:.. r
lcjj�of Commencement may t0t�Jt ' in, payi
-failure'td, 116COM a Not Jjjic,rkot&,of,St-.
ININGTO,.OWNERP-1our I Record I .. .1 r � 'i - rOct ,the puce
impro�em
A*N 6,
ritend to�.6mbtan
if f men
rty
the t �n
C' �����p n �6,Notice t ��ce
' ' si 9t�cb '0� e f rs
and 6�or
0� Pd - on b te
your
e t -i i Wo rikor recor�di
s- y rty. A` 0 nd 6 61 f ahC g consWt
-e t posted'
f menc n
r N nence. in
7- mus :�e
'WAI Y 666�ofCom meni�
LU�ie County'
oun ry n r e ore com
.or
with lende . a n�a 0 ne
Signature of Owner/ Le'ssee/Contractor as Agent for owner
Signature of Co`ntracto�rlcense Holder
c,
STATE FLORIDADA
R D
STATE, OF,FL09ID
,Of:'o 'Y
TY�,QF
CO.UNTY.'
swgxt'fo (or affirmed) and subscribed before me of
Sw o (or affirmed) and subscribed before me of
rt ization
P'?Physical Online Notar*
Physical.Pre ce or online Notarization
Vby
PreseW or
Th7js--& day of 20.)j by
this ,day of
y
Namd Of person making statement.
Name of person making statement:R
Produce . d Identification
Personally Known OR Produced Identification
Personally Known 0
Type of Identification
Type of Identification
Produced
"iduced
(Signature, ',PubliAtA �ld
of ISSIC)N it CC,
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My COM
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AUDREYB.t:
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Commissio PIRES:
'Vmflters
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Bonded Thfu Notary
"..;5 -'.0 rtnnd'
REVIEWS FRONT ZONI�G
I COUNTER , REVIEW
RECEIVED
LETED
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LE MANGROVE
PLANS VEGETATION SEA TURT '.. I W1
SUPERVISOR REVIEW
REVIEW REVIEW REVIEW REVIEW_