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HomeMy WebLinkAboutBuilding Permit Application To: Page 4 of 5 2015-06-03 13:36:57(GMT) 17726733383 From: Maritza Ramirez-Carpenter
li,A4 Pl1 ABI E. IV150-MUSTIBE CQMRLETEI3.FOR APP3 CA7[C3;Q1.�,i E:.P�I CEP EiD. " . I
nate;. t` Fermit:Number:
Planning and DevelopmentServices
&.utldlrrg and Code Regrivtioi�'tJivision
2300 Vi.'(712)-462-
pinia-Avenue ,FortPierce FL 34982
Phone: (772): 62-1553'. Fax:(772)462-1578 Cam. me.rcia.i � Residentibi
PERMIT APPLICATION FOR:
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Address: -7-6y q
Legal Descrt tion. ' 'Gc't'c d� 4T V?A&WA �x'7�
Property Tax IQ#: y a`j - d - 6116 - 6�0 0 :Lot-3 No. _
Site flan.-lame: Block:No,. 1
Proje.ct*Name.:..
Setbacks Front Back:_.RighV$Jde: �,o Left'Siide:
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,;.. y Ai yM Y T"38✓y v �C L .0'a S i "(' �. -4 .F XI`.
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+' > it. �._ ?a.. :Sl ..°1r....,_ a`tilea n i:w 631.. . „'f�'�t'r � SS. f IR
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itiQfsa war to.. e pe Orme. t1n: ert. �s permit—cher a t
Mechanical G.as Tank .Gas..Pipin . .... . _Shutters _Window. sjl�oars
_.Electric YKPJUM.t i.rrg Sprinklers ' !Generator _Roof
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Total Sq.Ft of Gonstructioa:- act,El-of Firs.t.Floor .�
Cost:of Construction: Vtiliiies: Sewer Septic Building Height:
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Address` Company,:
City; ` State-F.-C, Address
6Zip Gocle: ^�� Taxi' ff`I 6t CityT z-- State:. ii� l
Phone.No. � )" _ �..0 ..=n.rm .` ._n_. . Zip Code:.
E-Mail- K'1 11� Pl�o.he IVa
Fill in.fee simple Title.Fiolsier on next page(if different. E-MailI rl•�b00,
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frons the O.vi hO listed above) State or County License P I14
If value-of construction is 2540 of more,.a'RECORDED-koticeof'Commencement is required. �
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To: Page 5 of 5 2015-06-03 13:36:57(GMT) 17726733383 From: Maritza Ramirez-Carpenter
1
RDE$1603NIER/EN61NIM _Not Applicable IVIO�t°fG/�GE r��l!lIPRiVY: ` Not Applicable
I Nam-p: Name:
Address:. Address:
City:' State: City: State:
Zip: _ Phone Zi Phone:
FEE SIMPLE TITLE HOLN?M �Not App,lieaiile BONDING CCIIIPNPA.NY:^T _Not Applicable
Name:' Na.me-
Address: j.Address'y
j.City:.
'( Zip.: Phone:. ! Zi.p: Phone:
iC►WNER/CQNTRACT®R AFF.IDVIT:Application is:hereby-made.tp obtain.a,..ermit to:cia.the:'worlca.nd installation a5.indicated:.
1 certi#y�that:no wo'r.k or''tnstaliatiorl hascommeraced pnorto the'issuance:uF a,p.er..mit.
St. Luc` ountyy_makes no:represeniatiori thax isgraniingapermft will::auth.Qrizethe ptri
ermit.hafder'' .buildthe.sul�ject:structurE
which'is in co'n.Tlict.vtlth'any aoplic.able.Home Owners A'Ssocration rules,.bylaws or and covensnts:that'may restriet`flr'proNbit.such
structure. Please consult'innth your Home f}wners.{3SsQci6tioh and reviewyrour cieed:fo.r.any:restC.ictlans'which.rnay apply..
In consideration ofthegrantingofthis:requestied.permit,I do her..eEiyagree..that 14itl,inalfrespects,perfiorm the work
i ih accyfdance with the.approyed.plans,'tbe Flor:i.da l3uilding Codes:andSt...Cticie Gounty.Amendmerits-.
The following-building.permit,a.pplicatioris aee exerrj.p#.frprrr.undergoing a full.,00ncurrency review:room additions,
accessory-structures,swimming pools,fences;w:�lls,signs,sere?n,.rpoms:ancl:aceessory,u..es to another nonresidential use
W—ARNIN.G TO'INNER:Y urfailureto Re.cord:a.NotiCe:.of oCo.mrnencement may-resa.It:n:your:payirig twice for
improvements ta.yourproper .A:Notice:of Commeoiwement must be..record and poste on the job&ite
6eFore'.the first i.ns.e i:oo, if. u i6Vand to'obtain fi.naridrj&:consu -W.th ie o er.-a, an a rnej+before'
etimmenci uva or ecor your Notice:of Commencemenk.
Sig attire Fbwner/Agent[ essConntracto•�. Sa ria#tire of Contractor./L!cense l fifer- y i
STATE DF F ORIDA STATE OF FLORIDA
COUNTY OF; `� �S _ COUNTY C91=_
l The•. rgoin instr. rnentwasacknowled ed be€ore:me Thef � Qii1 mstru,.em:'vas acknowied e. before.rne
: r? 6 g: g ... B
#his. day,sof:
20' this' 'dayrof 20.
5 `
Name:of
{Name of person:ackno�vled ing.l. { person ackngyvledgi.np•.
' I
l.
{Signpture..of Nbtary•.Publ.ic-.tate of.fi (�igna.t re'of�Ngtaryr P.ubt,
:' ate Of Fi ri,.
1 Peusonally:Known_ t}.R Produced Identificatibn: l -Personally.-Known Produced I enti ,
TYPe'of.IdentificationType of identification' t#a
Produ.ced�• __ :e:�i' .: � .1 .���ed:
is ti .—:.
$T-AAT". ssion No.
Commission No. V, ,
C 11
,
REVIE:M i :t.R.©.NT ZONING. SUPERVISOR. PLANS VEGETATION SEA.TURTLE MANGkOVE I
COUNTER REVIEW REVIEW REVIEW f REVIEW REVIEW I REVIEW
DATE
REdIVED i
DATE
CQMPLETED � t
i