HomeMy WebLinkAboutBuilding Permit ApplicationAll APPUCABLENFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Number:.. umb r",
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Building Permit, Appikation
Planning and Development seriices
fiuilding•and cade Regulation.Mvision Commerciat Residential
2300 Virg ' inia Avenue, Fort Pierce FL 34-982
Ohone:,(772) 4627-1553 Fox. '(772) 462-1578 CBDG Funding
PERMITAPPLICAT cle-
ION FOR:
I PROPOSED.IMPROVEMENT LOCATION'- 'R'05- /VQ!5L
Address:
--C,+-- F� p rce IV9117
Property. Tax, ID #: 7- 6 03 - 4LIO o;2 — 410 0
Site Plan Name:
Project, Name:.
PTION OFWORK-:=
-ei dw—W c an vi e
t we
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New Electrical Meter Second Electrical Meter, I — (Affidavit required)
Lot No.
Block No..
I coNsTwaioN INFORMATION: I I
Additional work to be, performed under this permit- check all that: -apply:.
—Mechanical Gas Tank = Gas Piping —Shutters Windows/Doors Pond
Electric Plumbing Sprinklers Generator —Rdof Pitch
Total Sq. Ft of Construction, Sq. FL of First: Floor:_
CPstof Construction:$ c Utilities' —Sewer —Septic
Building Height:
OWNERAESSEE:
-A
CONTRACTOR:
Name' 5 a
Name:
- 41
Company:
Address: Cd-
i e rcc State:, &
Address:-�00 15�-- "t'd
Zip..CcfcIe:3'Y-IYI Pax:
City: State:F,
(1
Phone No. -3'0--1.ZY-7 E-
Zip Cod Fax: P%— A-
Phone No -17.3-
Mail-
Fill .1h fee simple Title H61de'r on nextpage. (if different
E-Mail C PL -aLOWI &"4 �j/?-(-e LP76 6 IvAd"I
from the 0wherlisted."above)
State or County -License
it name OT COnSIMMOn iS,Z5UU or More, a RECORDED Notice of Commencement is required.
if value af.'RA,VCIs,$7,S00 or more, a: RECORDED Notice of Commencement is'reqpired.
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City of Stuart AP0705QP16
._A,:.r,,,." EFE531t
CHAPMAN
FEN�'.�E� fG. 4'
65lY S E: polyneslan:Arcenug': Pgti g{ Lpae; FL3498 :
Office: iT2 40-y241'
,�;,,,,„s;�rranrpinrfrsamaii ! `w wwc iapmanftcemo:C0
.,,'w4�...c4y.cawa�c4n. ,I �!4�Vi /'��{r�S. _"."!�.�. l�k\f�}i R`M!'w+•��._.�..�. �...;-: •.ram
Name: filame.
Address: Address
City: _ _ State _ City:
zip: . Phone r Zip Phone _
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FEE SIMPLE TITLE MOLD -Not Applicable BONDING CCfIlAPANY
::Not Applit�b
_...
Na"me .. 4 J!tarnes
.
Address.. _ Addres
Ciw... , I Gty :
Phone: 1 Phone:.
GWNER[ CONTRACTOR AFFIDVIT:_ ARpiicatian rs fie eby made t4obtain<a peK nitro do the,wortc and nsgllatton;as indicated.:.
l certi . that no .worfr:or installatigr ' has commenced prior to the issiiptice of"a perim!L
V
stroctuce: Please constiit dv�th your Homeowners. AssgGation and revrew yCur deetftor any.resuicuons w�zect mar aE�kxr. _ _ - _.
lnconstleration of the gcantfng of.th�s recjaested perrtlrt,. I do hereby agree that t tool), in aif'cespecLs� perform the work. `
in accorclanmwRh the agprotred plans, the Florida Building Codes`and 5t 'Ltrue County Amendnteritsx ;
The iolicvtirng bt ildmg;permit applicat�oiu are eict inpt fromundergoing a full cons urgency review'. room additions,;
accessory:structures„ 4% m!4,- aoIs, fences, .oral s; signs, 5creert rooms and accessorY:t�ses to andther non-tesidentiai use
WARNIl Qi W OWRER Your failure to Record a NOLCe Otto may resuttin pay1ng:twtEe inr
lmoroveraents to your, property. A Notice pf Commencement must be recorded. to the pubic records of.5t:
Lucie Count�f and posted on the jobsite.befdre ttte f rst inspection.. !f you' intend Co obtain financing, ceznsu{t '
OF
Sworn o'(or-affi(medj nd subscribed before me of �% Physical Presence or Online. Notarization
this day of✓ Zt)z 7'bjF
Nameo'.f Pierson rrrakm stateni �� �� g ent. ... ...... ..
Persorialiy Kitoum OR Produced. identification
Ty
pe ofidentiftctiort Produced. 1
(Signature of:: HQtary. Public -State of Florida)
Commission No. (ea =y�.►*'� •r•��.. t:ANCY J SHEA - .
Notary Pubuc State ofF[erfila
Canmf3tton # NH 2O935S
- ,.!�Y �mm. Expires Sec t4 TQ25
t3ondetl throu4tt'Nttfanal notary* A53i;:
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE.
COUNTER; REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RAIL " .. .. .... .... .. _.. .,