HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 2All APPLICABLE INFO MUST BE COMPLETED FOR;APPUCATION TO BE ACCEPTED
Date:- _ �1 .�y �� 1 Permit Number:.
�-
SCANNF-D
BY
COunty
St. Lucie
* - RECEIVED
guilding Permit Application
planning'andDevelopmentServices NOV 19 '04,9
8liilding;and Code Regulation Aivislon
2300 Virginia Avenue, FortPierce FC 34982 ST. Lucie C Ly, Permitting
Phone:'(772) 462-I553 Fax .(772) 462-1578 Commercial Residen ,_,
PERMIT TYPES
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_ .. ..v ..,...
Address: 5039 AMY LANE FORT PIERCE FL34946
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Property Tax ID i; � y so —10 ' 0( Duo b Cot No.
siteP lan Name:. Block No.;
Project Name '
Additionalwork o�beperforfned Gnderthis,permit —check allthatapply:
Mechanical =Gas Tank _Gas Piping; .Shutters Windows/doors
_Elctrit _Plumbing Sprinklers _Generator „Roof Pitch
Total Sq: Ft df`Construction': Sq. Ft, of Firg.. Floor: -
Cost of Gonstrudion..$. ���� --. Utilities:: _Sewer _ Septic Building Height:.
Name Yi - --
Name: OVN n Is I t O
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Address: CZ� ciO14G. sip �O
'Company' id .S c
;Address SW - A VS -
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C(tys LQ19d2X \� _State FL
Zip Coder ��3� Fax.
City State:%(
Phone`No,Ci5LV,7a\L671,TE� __
ZIP Code :I) Nnc)_ Fax
Phone Nog5q—, �5(01— l9acf -
E-Mail.ARdcc9LC94A j0Q MaQ--0t%"t
Flil in fee simpleTitle Holder o -r,4i page (if different.
E MaiI
State or'Cdunty License C AC Q 5113 0
'from-the•Owner.-llsted above]
ff value af.construction ls$2500 or more, a RECORDED Notice of commencemeMds required.
If value of HVAc'Ls'¢7,500,or'inore; a_RECORDED'Noticeof•Commencement is requred,.
WO
DESIGNER%ENGINEERS + Not App Ie
Name:
MORTGAGE'COMPANY: _ Not Applicabl .-
Name:
Address --
Address: -.-
City: State:
Zip: Phone:
_
City: - - State:,
Phone
FEE SIMPLE TITLE DER: . _Not Applicable
WrmO:
BONOING`COMPANYd ,Not Applicable
Name:
Address: _.-- -
Address;
CityS' _
_
City:
zip,Phone: _
Xlp: Phone:
piication rshgreby madeto obtain a permit to de.the: work and:installation-as indicite'd.,
menEed prior to the Issuance of a permit.
In consldFration of the granting ofthis requested permit,, I datiereby,agree that-] wdl ld all respects; perform the work
'in acctirdance VlO the approved'plans, th'e Florida Building Codes�and St. Lucie:County Amendments.
The foilowing 6uifiifng permit applicatioris'a7e exemptfrr m underg6ing a full Oncurrency review: room additions,
aeeesinry 4hicturesisunmmin'I&Doofk fences. walls. siens.. screen rooms and accessory uses to another non-resideiitlai rise
The fpp�gqIns instrum n was a nowIWge before me
this�rd3yaf�2U� by
REVIEWS I FRONT'
STATE OF FIL
COUNT1f of �RIDA
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Nameofperson making statement. ttttuumprr /'
xx
Personally Known OR Produceddiigg8tp
Type of l tif'ieaiion c° �E 1 z
Produced V2ms
#FF 9910M _
Commission No..;
FLANS VEGETATION SEA
REVIEW I REVIEW K