HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONMay 11 2000 02:22AM HP FaxMirandb Sale=_.7728710863
page 2
ALL APPLICABLE INFO MUST BE COMPLETED F R APPLICATION TO BE ACCEPTED
Date: l CANNED
BY Permit Number j`k 11 " (3a.GrJ
3t, Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2900 Virglnla Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462.1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSED iN,PROVEMENT LOCATION:.:
Address: nr� r
Legal Description: _ W � L o Zi. t--1 (` f� �l�y hL— \ (�
PropertyTax ID tt:VUW '.-L
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side:
Left Side:
Lot No.
Block No.
DETAILEDAESCRIPTION OF. WORK: i,,III
CONSTRpi T-fq INFORMATION:
tona to �eueorme un er Isperrni —c ec a appy;
VAC L_JCiasTank ❑Gas Piping _Shutters ❑Windows/Doors
®Electric D Plumbing ❑Sprinklers Generator ED Roof
Total Sq. Ft of Construct—io�n: S Ft. of First Floor:
Cost of Construction:$•�•{•-1q("/rtr�� 1-0 Utilities:SewerUSeptic Building Height:
OWNER%LESSEc - _
CONTRACTOR:
Name .7 r
Name:Wny-'
ArJtJess:
Compak
ikYState,
Zip Code. L
Phone No.
Addres���
>
> I
City: Z LJ� Lr to
Zip Code C
Phone No.
state:.
Fax: ('
E-Mail:
Fill In fee simple Title Holder on next page ( If different
from the Owner listed above)
If w?!L
E-Mail v Uf-' +Cif
C: �; < e
State or County License:
L
—'-- ^--••-•• ^^• ••^ + vww v, inv,c, a n, wnucu vuuw ur uummencement Is requireo.
cIr
May
11
2000 04:25AM HP
FaxMirandb Sales 7728710863
May
11 2000 0222AM
HP FaxMirandb Saes 7728710863
page 1
page 2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
�, Permit Number; � a.60
Building Permit Applicatlan
Pronning and DavelopmMe Services
81fpoing and Code Repvlorlon Dlv/s%on
240 vilginlo Avenue, fort Pfaree FL 34982
Phone;(772)452•1553 Fas:(772) 462.1578
Commercial Resldenriall/--
PERMIT APPLICATION FOR: To Select from drop)
PROPOPROPO E OVERdENT LOG4TION:.
Address: D
Legal Description:
click horn
Property Tax 10d:i,k4VLC
51te Plan Name: '--
Protect Name:
Setbacks Front Back: III&Side; Left Side
N OF WORK:,,
W4HVAC I..,J Gas Tank i�IGas Piping U_Shutters
❑Electric OPlumbing Sprinklers Generator
Total Sq. Ft of Construction
+—y ,1 ITS $ Ft, of First Floor: _
Cost a l Conttm etlpn; 5 �• y1(14 Uenitles:�Sewer gSeptic
Nome:
Statelk-"� Address:
21p Code. l {
Phone
iro- r C. City: 1
�
E•Mail: Zip Code•
Ic
Phone No.
Fill In fee simple Title Holder on next page ( If different
from the Owner listed above) E-Moils
State or County Lleense:
`�, - k 4
L,nw nuul
aulldIng Height:
13 $2500 or more, a R'C nwEDNotlea er[er.... ___-.._ __ jiilu4•
May 11 2000 02:22AM HP FaxMirandb Sale, 7728710863
page 3
SUQPLEMENT7�t4
NSTRUCTION.LIEN LAW INFORfv1ATI0N `.:
DESIGNER/ENGINEER
Name.
NotApplicable
MORTGAGE COMPANY
NameAddress:
Address:
City: State:
Zip: Phol e:
City:
Zip: Phone:FEE
iERd
SIMPLE TITLE HOL ER: Not Applicable
Name:
BONDING COMPANY: _pp
Name:
Address:
Address:
City: —_
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and Installation as Indicated.
I certify that no work or In tallation has commenced prior to the Issuance of a permit.
St. Lucie County makes no epresentatlon that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with an applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work
In accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room addltlons,
accessory structures, swimining pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNT, Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to you ,property. A Notice of Commencement must be recorded and posted on the jobsite
before -the first inspec{ion. If you intend to obtain financing, consult with lender or an attorney before
STATE OF FLORIDA STATE OF FILRTJ
A ,
COUNTY OF COUNTY OF
The forgoing instrument wI s acknowled a before me, gy:yac,� The forgoing instrument was acknowledged efore me
this _ day of . 2� by R' P4 this _day of . 20k by V
(Name of person acknowi
dging) a
(Name of person a a[cckknowledging ) y
I g a
%�///J
,/I d
(Signature of Notary Publi
- State of Florida) o g =
IB^ature of Notary Public- State of Florida) a �,
Personally Known
R Produced Identification
Personally Kncwn`GR Produced Identification
Type of Identification Pro
uced
Type of Identification Produced
s`-'�-�
Commission No. ' —
�S (Seal)
Commission Ng- Seall
Revised 07/15/2014
REVIEWS
FRON
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNT
R
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED