Loading...
HomeMy WebLinkAboutSUBMITTED PAPERS1E p �w,-�t ;. St. Lucie County Building & Zoning ' ?'s 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 Tel. 561-462-1553 QR1Dp' SPECIALTY PERMIT APPLICATION n ❑ Electrical ❑ Plumbing- ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition 0 Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: 9/.3"'? L/mv�s 1< tz 2. Parcel ID Number: 33,72~ 2a7 - e607 - v60 Z Only '?roymshi -Range--J Map Page I Zoning Land Use... __InWals___ -_. _ . _ _._... 3. Description of Project or Work Activity: "r."I 1, R Oct I a `L Cloa/r ! Q 4. Owners Information Name: / /,-, oC L�S� Address: ,S— ItJ000 -106-f Or City: e%%-, State: /v l� Zip: Dad 5— ) Phone: 6. Value of Construction: $ A�06.6r' 5. Contractors Information FL Reg/Cert County Cert#: 29-!5'7 3 Business Name: 19m e i a y Phone r'33 'o700 Fax 27Z- OWNER'S AFFIDAVIT: I certify that all of the information contained, i` this app ca on is rrect and that all work will be done in compliance with all applicable laws regulating", struetio 2onin . PRINT QUALIFIERS/OWNERS NAME SI TU ' OF QUALIFIERIOWNER STATE OF FLORIDA, COUNTY OF/ J / L U C 14 ACKNOWLEDGED BEFORE ME TIES 0_:DAY OF �,aiuv.7� 201`L, BY,��nr� L iccr s7r, WHO IS PERSONALLY KNOWN TO ME R WHO HAS PRODUCED AS IDENTIFICAT/ION. //� (seal) SIGNATURE OF NOT TYPE OR'PRINT— NAME OF NOTARY TITLE: NOTARY PUBLIC St. Lucie County Specialty Permit Application rev. 8/25/05 dmg COMMISSION NUMBER rlZ— MICHAEL MILEY ••'_ MY COMMISSION * EE217600 EXPIRES July 16. 2018 (10�SpB-09'S3 FIaIQaNa jx f r a0 ST. ]LUCIE CCUia1TY BLS' DING DMSIOW CE RENEWED FOR CO REvrmvWwE B DATE T 1VdU6I BE APT ON JOB PLANS Al I P OR NO NsP ECTIO'? NVILL BE nV kDE* ZIrtj*"5 tL-"'7 8132 Links Way, Port St. Lucie. FL - Google Mapg Page 1 of 1 To see all the details that are visible on the screen, use the "Print' link next to the map. https://maps.google.com/ 1/21/2014