HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR AFPUCAMN TO$E ACCEPTED
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Building Permit AppliCation
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Pfanning and Deiwk)prrwnt sar++m
5 CnYdiaY W adtr RcV uiodorr Orvrsicn Corn me uJal Resid a ntia I
,7XV Vjr!0rr7i(r Avenue, Ford Pwrrr FL 34!982
Ph,Drw. M21462-1553 Fax,(772)462-=57 E CBDG Fu nd i rpg
?ERMIT APPLIC-ATION MR: -
P.ROPOSED 1 M PROVEPA E NT LOCAT I ON
Address: x f
Property Tax
Si to PJa rr Name: _' r r q E; Bkxi No.
131fUJea Name:
` DETA1--ED DESCRIPTION OF WORK -
New E lectrice I Ml ter Second Ueetrrcal ML!,.te r_ [Af,(davit re-4ui red)
CONSTPUcf oN INFORMATONk.
Additicnaf wo rk to be performed under this permit-chark aft that aPphy,
_Mecha n ics I _43as Ta rLk _Gas Piping _Shutt-ers �ind�ws�Dsxtrs _P+orr�
Electric _ Plnrnbin.� _Sonklers _Generator P.?DDf Pitch
Total ,- Ft of CwArurtion_ _ Sq. FL of i iFst Flow:
Cost of rkstruction- , - ijtiElt9[ts= Sept Bu M ing Height__
OWNER/LESSEE. CONTRACTOR.:
Name rcLLZ n la_ Oaf lix3rl Na me_ -'FY a0'
Zi p Code; LL Fe_x_ City;%+ � -T LLr_j4 —.State: Ir�_
['h rre Na. i t E- zo C•c]de= q q_S,- Fax:Mail t Ebe IIi&V n . r Lea, Phone No-1-IT-79 S - an _
Pf Il rn fee slmp[e Title Holder on next page jif d If#e rent E-Mo it R•q 14 Z ti rr-s
from the bwmkr listed above) State or County 1jcense
If valve of construcUon iS 2500 yr more, a RECORDED R13tice of Comr.n.-errt enz is requlred,If va lee¢E HA VC is S7, 00 or more, a RFCORDE D tdo rcr �f Com meocemer:t F,req udred_
SUPPLEMENTAL•CONSTRUCTIO N LIEN LAW INF0RMATION' '
DE5t61N EN NEER: N at Ap p!icab le MORTGAGE COMPANY; N of Applicable
Natr e: Name,
Address; Address:
uty, tat : — City: Staff
Zip- _ Phonc! Zip:= Pao
FIFE SIMPLE TrILE HOLDER: Not Applicabli2 - BONDING COMPANY; Not AppIie-abie
Name- Tame=
Address: Address: _
City- City:
Zip. mone: Zip;
OWN NTRAGTOR AFFIDVM.App3icatfon is her-uLv rnAe to obun a permit to do the work and frlska'alatiM as Lndiicated_
I certify that nu work or inskaklakion Ek%oommenced prior to the Issuance of a pe7nl4,
St. Lucie Cqurrty rail no re frr nlation that 1-5 ril- a p it wOl authorize the pereri it holder to buf{d the subject raruc.#ure
which can icts w kim with anj appble Ho w mecn-Crs CMa ioh fuIe6,bylaws aw and cmwe an s that may testiq o6r prohibit such
structu re. Please wrisu t with y Dur L-Lflmeowrters Assodatlon ance review you r dew far any�estrktivns whkh m;ay;appEyr-
In van:4dervfio i of the granting of thcs requested permit,I:dio'hereby aKrcu the L 1 will, In al respecu, perform the work
in amordanre with the approvud Wan5,thc,Flixida.0ud1¢Ing todes and St_Lucie C"rrty Arn- rOdrr«cnt5-
The folli2ywl!n8 buiiding peimFt app3ications are exempt from urWergolnU o full ooncu:i-reric}review: roam additions}
NcessDryr structures,swimming pony,fences,wWls,sins,screen rooms and accessory uses Lo another rkotl derixia1 use
WARNING TO OWNER;Your fail u re to-Rerardallotj cm of Comtne nee rrM nt may re:FLult in p a y I M tw iCes. 1`13r
im pro,rements to you r p ro pe rty- A N oti�:e uf Co m memer+'eat M List be recorded i n the publ is re0ords of-St.
Lucie Cuu my and po ed -vo the jobsite before the fi rst i nspection. 1f you intend to obtain fina ncing,con suit
with '.o.rtder ar a n attorn cy befare acimme acing work or rE?.00td i ng your Koti-Ce of C4Dmme noerrment.
U14d 'Wil
i Si n�of owned Lene-eJCA3ntracEor as A&& n[for o' neir
SrtTyATNE7OrF,+FLORIDA 'r
i Swcirn to(c•r affirm and b&albed before me of Pkfy+51ra1 presence ar Onlinc AEuwr=[0tiori
this.fL L .dayC4 20.74 by —
Nance of parson making stat,wwnt,
Personally K"wri OR Produced Identification
-L'VpL-of identification Produced
iS4 awre of NDtary Public-State of F106dls1
Comrralssion fRFINF.CIA
I MY ixl�r��SEON aGG�SdS
D[.I'1FF3:Afmf 12,
REVIEWS FRONT ZD N I PIG SUP;ERVISO R PLANS VET FEATLON SEA TURTLE MA N-:3 RGVc
COU NTER REVI E'W RF-VII�W REVEEW FkE '1 1 ' REVIEW REVI EW
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RECEIVED �
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