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HomeMy WebLinkAboutBousson App11 APPLICABLE INFO MUST BE COMPLETED 1=0R APPLICATION "CD BE ACCEPTED Date;:,:, Permit Number: Building Permit Application Planning and Development Services euilafi,ng and Code fiegulatian Division 23�:7`Virginia Avenue, Fort Pierce FL 34982 Phone: (772j 4f2•�L553 Fax: (772} 462-1578 Commercial _____-__� Residential PEi�fMiTTYP�: �; Property Tax ID #: � _ - Lot Na. 7 Site Plan Name: �� Block No. �r�;,.. nal work to be laerfarmed under this permit -cheek all that apply: lechanical � Gas Tank -„_„ Gas Piping _Shutters "�' 1=iectric _Plumbing _ Sprinklers � Generator Toth-1, Sq. F`. cF C'nnsrr{a;=tlon: _�.-,,._.. Sc�. Ft. of First 1=1oor: Cast''of Construction: $ .��1� • � ,,,,_, Utilities: �, Sewer T Septic Building Height; Address: � ]O � Citi'�; �0!!� ,,_[(Qi�'..�- State: Z�;� Code: �T��- Fax7:l�-` Phone Na, �� `" `�' E-��lnii.--�-�--~�" Fill in fee simple Titfe Holder on next page (if different: from the C+wner listed above) �iWindows/i7aar� i2oa# � Prtch Name: Company:.lu4l�tk F�r�r�,,SL � l�eil[u��L1�Sjc�-�R Address:I[D C3,r�rhrt�,J� bfr Dom' City: „f�..1 States; � zip Cade: 3ag3"[ Fax: �aE� 717-`�� �,_�. Phone No '�^ia,--337� �#'f7q .. �-Mai! � �- State or County License I� If uaiue of cvnsYruc�ioxs is �2500 or more, a RECC}Ri31=D Notice of CvrrsmenCement is required. If value of �IVAC i5� vi,5G0 or more, a BECQitDED Notice of Cort�rnenCQment i5 required. ;E: � E' rr: ' DESIGN Narhe� Add'�e Citys' Zip�`�_: I[iIEER: _Not App Phone __ State FEF�lN4Ri� T!�'L� H�DL�f`�f: ---.Nat Applicable Narrie: ess: ZiK>: Phone: MC1R�'GAGE COMPANY: � Nat.Appl;ca�fe Name: Address: City: State: Zip: ___-- Phone: - BON)�ING COMPANY: Name: Adclres,: c;ty: Zip: P}�ane: Not Applica ilVl1#EI�/ CONTRAiT4C?R AFFIE)Vli': Application is hereby made to obtain a permit to dv the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. t. Luci:c_= t:o�sstu srrakcs n� r epreses�tation that is granting a permit Wviil auiho,°ize the permit holder to build.the subject s#ructure hick pis in conflict with any applicable Nome Owners Assoaation rules, bylaws or and covenants that may restrict or prohibit such tructitire, Pleas. consult v�'ith your Hame Owners Association and review your deed for any restrictions whrch may apply,; n cvn'sideratian of the granting of this requested permit,, I do hereby agree that I wi;l, in a;i respects, perform the work ' n accp'tiance with the approved plans, the Florida Bu'slding Codes and 5t. Lucie County Amendments. h2 fo�lloluing building permit applications are exempt from undergoing a foil concurrency review: room additions, cces:rr�ry strurt.!Ir��s, swa�nrning pools, fences, walls, signs, screen roams and accessory uses to another non-residential use l+1��OIIN>;: i�0 +�V11NER: 'IPOUR 1=AILU12iE �'O RECORU A NOTICE OIF COMMENCEMENT MAY RESULT IN li'OUIt I'AlrING '1'yl!1��� f>rC1lE�' LFalfi"R�D�EC9�IEIeNTS TO �S°D�.1R P[iOPIERTl(. A NDiiiC;E Oif COMMENCEMENT MUST BE RECDRDED AND i�(T�TEII� .iAN TIFIE .iAEf SITE BEIFfl1FpE "1'fF1E FIRST IN5I�ECTI01'+P. IF YC3U INTIEND TO OBTAIN FINANCING, CONSULT i'irlA"II °l�Ii�R �,IEi�i[1EIF iDR AAI'A't'IfO1RNlEY SEr=ORIE RECORk�ING 'St'OUfi NUTiCE ©F COMMENCEMENT." Signature of Owner) Lessee/Contractflr as Agent for Owner Ct�l,r�l�"'� C'�'--�---------------------- The �`�rj;oing ii��strtarrrzr,t was acicnUwiecaged i.iefUre nze this `?�_ day vr' , 2D_ by of person rralcir�g statement Perc�ii�!!iy Kn�wr• ,_,,,._.___ OR Produced Identification 'i'viw�+.��n�i rc?pntrficatirr� ture,3f N�,tary Public- State of Florida } issivn f�'o. _..,�-_. ___� {Seal} Signs ra of Contracto License Holder ;TAT€.' OF: F�.�3Fil®Pl � � 1'i•,a fv � uing irrstru ent w acknowledged before me: this�dayof 2t3� i3y Name of person making statement. Personally Known � OR Produced Identifcation�' _ 'I"ype of identlficativn Produced ,, ;� k:., (Signature o otary Pu lic- State of Florida } Commission Ro. �' n��er�� `O�+a a ubl3c State pr Florida �° ' �; Ashley M AntonelEi .��._._ - ka r v.... � .. ,' , _�...._.._....�. _., .,�..w_____�-- __------�---- � nF '�w Cxpire • 1 fl11 B12E)21 RE.VlEWS FI:3UN7' ZONING SUPERVISOR Pi.AN5 VE:GETAT;ON CC3UNTER REVIEW REVIEW REVIEW REVIEW REVIEW RE1/IEiN I DATE' RE.r,�iUEG' �----- DATIM. CuM�I.�.TF.C) �__._ A—•—L----�-- —..._. � —�----