HomeMy WebLinkAboutSand Dollar Shores Building E Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO 13E ACCEPTED
Rate: - Permit Number:
0TC11�LCC11J}'9 .�
ji '>'•'n :`, o' a- ;;; Building Permit Application
Planning and Oevelopment Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PIwRM1Y APPLICATION FOR;
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,Address; b T. 4 j /1
Property Tax ID A bldg. Briii! 60� - ef)e_ ._
New Electrical Meter ___ Second Electrical Meter (Affidavit required)
Additional work to be performed under this permit- check all that apply.
,,,,_,Mechanical Gas Tank ,_,,, Gas Piping ,,,T, Shutters _ Windows/Doors — Pond
,,,,,,, Electric ,,,_ Plumbing Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ `� K . 00
En
Sq. Ft. of First Floor:
Utilities: _Sewer _ Septic Building Height:
City:
Zip Code:. Vqs- ., Fax;
Phone No,_- - 3
Fill In fee simple Title Holder on next page ( if different
from the Owner listed above)
Nd me: , =JC,,([ J. t __ l ,-r) !lt l ^+ 6&j df'4 ,2 it'd
Company: --
Address: /066 /) le en
City: D JM,0,24 B .t 0 State:, (-.
Zip Cade-3J.. Fax:
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Phone No--�1_ �: '��4a � *?_'5',3,T
E-Mali A-40 C KS
State or County Licen
If Value of construction is 2500 or more, a RECORDED Notice of Commencement is regv
If value of HAVC Is $7,500 or more, a RECORDED Notice of Commencement is required.
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MORTGAGE COMPANY:
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Not Applicable
Name:
All
Acldress.
City:
1p:
Z' - Phone:
-State:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY.---'
Not Applicable
Name.
Name -
Address:
Address,
City:
City-.
Zip: Phone:
ZIP: - Phone:
-- --I �+ lvl"rs'%,#%J"P%rriLOVII;/AppllCaTion is nereny mabe to ootain a permit to do the work and Installation as Indicated.
I certify that no work or Installation has commenced prior to the Issuance of a permit.
St, Lucie Coun make $ no representrtion that Is granting a ermit Jill aut�orl theit holder to build the subject structure
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which Is In Conflict with a7 appIlcab le Home Owners Association rules, by aws or an covenants tnrt may grict or prohibit such
structure. Please consult With your Home Owners Association and review your deedr any restrict ons whic may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
In accordance with the approved Plans, the Florida Building Codes and St, Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review., room additions,
accessory structures, swimming pools, fences, walks, signs, screen rooms and accessory user, to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in twice for
improvements to your property. A Notice of Commencement must be recorded
Lucie county anUicisted on the Jobslte before the first Inspection. If you intendrn the'Public records off.
to obtain financing, consult
wltlXie,ncler or 0 orney before commencing work or recordInar vour Nntit-.0 Af rnmmiamrame3vif
Ngnatur U er/ Lessee/Contriitae as Agent for Owner
STATEO%'31RI0A
COUNTY OF tiV - I
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Sworn to (or affirrqed) and subscribed before me of ,physical Presence or_ Online Notarization
this day of - ItIVIA 204 by
Name of person ma- king stqternent. I
Personally Known OR Produced Identification
Type of Identification Produced__
(Signature of Notary Public- State of Florida)
notary PuDi�c State of FIGHOIN
Commission No, C-rG- 23938 (seal) Ato"ridre Kuaon
My Cornmlmlon GCS 230301
REVIEWS 7FRONT
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
OUWER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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