HomeMy WebLinkAboutBUIDING PERMIT APPLICATIONAll APPLICAM l"fO MUST BE COWLETED FOR APPUCAMON TO BE ACCEFrED,
Date: i4a4p, Permit Number:
''
Building Permit Application
Planning and Dewkpirient SerWces
Building ard Cade Regulotian DiWsion Commercial ✓ Residential
2300 Virginia Avenue, Fort Pierce FL 34992
Phone. (772) 462-1553 Fax: (M) 462-1578 CBDG Funding
PERMIT APPUCATION FOR:
PROPOSEO-IMPROVEMM LOCUtON:
Address: -1 Oq t 0 5 0 c egn bt- i 3*Mgn eW,6 J=- L 2Y')57
Property Tax to #: 94,511 -51LI - 5 000 - 000 19 — Lot No.
Site Plan Name: MOWAe. $;+C I`Ylq&CAMon A a PC>3QQL Q-1 Block No.
Project Name: i2
OESCRIPTION OF WORI(:
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit -check all that apply-
(Affidavit required)
-Mechanical —Gas Tank —Gas Piping Shutters Windows/Doors Pond
& Electric — Plumbing —Sprinklers — Generator — Roof Pitch
Total Sq. Ft of Construction- e_x; SV,. ir\Q sq. Ft. of First Floor: r\A
Cost of Construction: $ ca 5-00 Utilities, _ Sewer _ Septic Building Height:
CONTMUOR.
Name T- k e,
Addressz S q0t ekficLrv-r% Cntr br,!N-= lip Ft -46
Ci -"- :1"r tt State: =L
Zip Code: S3(,,,314 — Fax:
Phone No. —'%!a -453 - "!?'I E-
Mail: AndU& J"22 kQkMO JP_Q_,mAdinIda ca*Ao,"
Fill in fee simple Ttde "older on nod page (if different
ftom the Owr" Wed above)
Name: lv C
Company: E:rlp§scX_ J!r1c
Address: to5vo �fzcv_q ne
City: 10'"0 V I State:
Zip Code: "750al Fax:
PhoneNo q&,I-q,7(
,, -to&37
E-Mail S+"r -ti *4 ekp
State or County License CX7:C_ 1518ss�
I
U VOUM 9M u—n—un 1w z-nm or amm, a KtLumitu nwt" or Lamminvcemerst is mquirea.
If value of HA YC is S7,W or mcirs, a RECOWD Motive of Cwnmenoernent is requked. 11
acne:
{:
dip. pit �e
:y;
Ott.
�cl�l
Zip: Phone:
�� �� � ��: _ Nat �r1�
�I�G ���v;
�i�t4'Ttf�:f`Y7�`as�tr,n'�{t�srsc� C3s+c�s �[a»rle �.�r�
��ltt1
Address: ��i�►'r �r
Address:
Zip: 3s#+4,�"'?'` P�loiit�.?�
ZIP. �1�:
city: eavza agq�&h City:
QWNW CO*T A� AFRMT: Application is � made to obtain 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. ie Count tr�me s �ii +gill a�rize the perrnt holder to build the subject structure
sure Mae v�rth � maws or wW covenants that � � or proh t such
your Norneonrmers Association arty review your deed for airy restricooft w# may appiy.
In consideration of the gram of this requested permit, I do hereby agree that t will, in all respects perforrm the wore
in accordance with the approved p%, ttre Panda &uk bng Codes and St. Lucie County Amendrrr ts.
The 16110 hV �N3 permit applications are exempt from undergoing a full concurrency review. room additions,
acae rysbuck res, swirmm�g pool, fences; yaps, signs, screen rooms and accessory uses to akodw riot -residential use
W TO t 11i NElk Vow � to Recwd a Notice of Conuviencenwa may r estift in payft twice for
IM n + to your property, A Notice of Commencement must be recorded in the public records of St.
and posted on the tr ite before the first inspection. If you intend to obtain financing, consult
nor or an actor before comm ' work or recur I your Notice of Commencement.
I�ESiGNER/E'Jr�iINIrER; Nat Appticatrle MOWGAGE �CA�1lt1xA�Y; NotApplicable
"T (oral rsubscribesl rrie of Physica.! Presence Or CkSiirle Notarization
this, (121variI
this
t+iatrte of
RECCo;"[)
lev
EIVED I
e raiOwner# Lessee/ ct Agent for Owner