HomeMy WebLinkAboutMackanics permit appAl APPLICABLE I N F 0 BUST BE COMFLETE0 FOR APPLICATION TO HE ACCEPTED
1) ate:
Pfinrrn irrg and Developm-ent Services
Pe.-mlt Number:
Building Permit Application
atij1din9 and Code R,-gulcrticn Divisrorl
3W VIrgirpia Avenue, Fort Pierce Ft .34 2
Phone: (772) 2-1553 Fax- (772) 462-1578
Commercial
CBDG Funding
Residential
PER M iT AP PLI CATION �O R_
PROPOSED IMPROVEMENT LOCATION.
ION:
}dress: �i tr4f �, i a L
grope ft Tax ID #-, 4�d - _ �CA DL� � r � _ Lot No..
Site plan Narne: Btock No -
Project Name:DETAILED DESC I PTI C N OF WORK
New E ler-tr i ca I Motor Second Electrical Meter (Aff1 d avit teq w i red)
'CONSTRUCTION INFORMATION: -Y
Add itionaI work to ha performed urnder this permit— theck all that apply-
-Mechanical
Electric;
Gas Tank
r � Pl ufnbing
Total 5q- Ft of Construction:
— Gas Piping
Sprinklers
Shatters
Generator
+,.,— Windows/Doors Fond
Sq, Ft- of First Floor:
Cost of Construction; Utilities: _ Seger _ Septic
OWN ER/LESSEE:
Name ~-J ),e. r
Address:
City: ` (� 5 , i c- State_
Zip code:1 Pax:
f i I l ire fee -,irnpin Title H older on n ext page (if d ifferent
from the Owner listed alcove)
CONTRACTOR:
Roof P itch
Building Height- --
Name(ad-1 42
compare{: t- ILA } L � f L-%,- � 74
,address : � f � � � ��� r ear-K. l u6
City- ' c L State r
Zip cods: -- I`a� `-
Phone Na-
E-flail
State or County Licen �. - l i #
If value of construct -on is 2500 -or mere. a RECORDED Notice of Corn-mencemerrt is required_
if era Iue of HAVC is $7,5W or rn are, a R ECORa Ea Notioe of Ca rn mencement is requ ired.
SUPPLEMENTAL ON TRUCTION LIEN LAW
DESIGNER/ENGINEER: at Applicable
Nam-e,
Address:
city;
7-1p:
P�iane
State:
FEE SIMPLE TITLE HOLDER: 1�,f7ot Applicable
Name:
Ad d ress;
City: _
Phone:
O NERJ CONTRACTOR
I certify that no work or insta
INFORMATION,
MORTGAGE COMPANY:
Nct AppIicable
Name:
Addrez-_
City: _ _ State:
gip; Phan-e:
BONDIN COMPANY: Nit Applicable
Name-
Address-
City-
zip- Phone-
N F FI DVIY: Application is h er eby mad-e to obrtai n a permit to do the work e n d instal lati on a 9 i odicate d.
at ion has commen-ced p rior to th a i:ssua rice of a permit.
St. Lucie County Mallke$ no r-epresentation that' gr �ltirl a permit will authorize the Wrrnit holder to build the subject !Wucture
which conflicts with an applicable Homeowne'A s"ON1 ion rules, bylaws or and covenants that may restrict or prohibit such
structure_ Please ccrisult with your Homww Tiers Asso6abon anti review your deed for any -restrictions which may apply -
In cons i d e ratio n of the gra rat i ng of th is reque-sled perrnk I do hereby agree that I will, Grr a I I reSpectsr Perform the work
in ai;corda nce with the a p p roved p I-ansx th a Florida Bu i iding Codes a nd St, Lu6co -County }rrier`dm a nts.
Th e fol I owing bu i iding pa rmirt ap p I icatiu ns a re exempt f rem u n d ergoi € g a full coriCUrrQnEY review; room add itic ns,
a uessury structures, 5wimrning pools: fent+esr walls, signs, screen rooms and accessory uses to another non -resitieatial use
WAfiNING TO OWNED; Your failure to Record a "ice of Commencement may moult in paying -trice for
im prove ments to your property. A Notice of Commencement must be recorded in the pubiic records of St_
I_u c ke Co u nity a n d posted on t h e aobsite before the f fst I n s peaio n. if you Intend to obta In fin a nd ng, -con su I t
merit h I.e n de r r'i attorr, befor-e com m a n cing work o r record i ng yo u r N atice of Isom me n ceme nt,
,T
re of cogs ictor -,Dr- - Own e r` kuilder as -a pp! ica ble
TATIE OF FLORIDA
COUNTY OF {
r
Svo o rn to (or affirmed) and subscribed before me of Ehys ira I Presence or online Nota rizartion
this d@y of � r 20 by
_ //" ,/,I,
farm rso n rn ak i ng state mervt.
Per-sorialIV Known OR Produced Identification
Type of I d entificatie n P rod u red
n atu re of ota r y P u bl ic- state- of Florid a)
Commission No. � �� AL RRAM0
CommIsgon # 013 328770
,lag, Expires April Nr2023
*7 .
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REV11EW REVIEW
DATE -
:RECEIVED
DATE -
COMPLETEV --
ev
PLANS VEGETATION SEA Tl_1 RT LE
FtMEW RVIEW REVIEW
MANGROVE
'REVIEW
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