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HomeMy WebLinkAboutSUBMITTED PAPERS'ate: V't I tj I Fee Due: V0 1 �d Receipt# . -'rmit # 14 d 3 -0 a01 Planning & Development Services Building & Code Regulations Division SCANNED 2300 Virginia Ave. �t BY Fort Pierce, FL 34982 �UCie COUn (772)462-1553 f� SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ RVAC 10 Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: 629f t Pe&Tr (TZUCtL , f L .3y96"-Z 2. Parcel ID Number: 34126-703-006 `-606,1 Office Use Only Section Township Range Map Page Zoning Land Use Initials 3. Complete Description of Project or Work: J Ai. 7rLL q% L-F. OF t'o //%9LL S/�f7Fl�dc� �a1C 4. Owners Information j Name: 1 LDC3L-1LT Address: 829/ cJl3/Vt�%�/i1lL� L fIi�CL� City: V ok.l J l Luct State: rL 5. Contractors Information Zip: 3Y9s2 Phone: 2o6-/90.' 6. Value of Construction: $ 860 F00 FL Reg/Cent #: County Cert#: Alk 2srsY Business Name: 4 fi d-&L— OWNER's AFFIDAVIT: I certify that all of the information contained in compliance with all applicable laws regulatin PRINT OWNER OR CONTRACTOR NAME SIGNAT ,91222�P23 Fax: 'VA9 -6272. STATE OF FLORIDA, COUNTY OF Cr- L j C.,L ACKNOWLEDGED BEFORE ME THIS V 3 DAY OF MAII-C-4 20 , BY is correct and that all work will be done in bHic'-,LCOL ' J i'vi LL-"/ WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED AS IDENTIFICATION. 3iVIS (seal) SIGNATURE OF O ARY L/ TYPE OR PRINT NAME OF NOT Jos• 4C�,-- -/,, COMMISSIONNUMBER 19C9390,T �n P® N� NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT �kMY'. c Yob SAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND T iN,1W411WMFr4 KNG CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTI EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $7500.00//�I'133 "�;``\`�. Revised 04/26/2010 Google earth A Gi,4i i-L-VCL:- , /if Srw-tL y7'L. F DF 6 r,*[- luuv- ivr Sl'w G Aicant has been advised NO structu i be erected within any easement or it of way unless othwwlse approves 31ieant I AWD feet 80 meters 20 ..,r©Ha[ 924f LAWPJAWL: PaciT Cr Luc, L , FL_ Ltr<s r�� Co 1=u�.ecr -9 W5