HomeMy WebLinkAboutBuilding Permit Application OFFICE USE;ONLX: DATE FILED JID 2,T)t,'I�Q PERMIT#:
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BUIL-_D '.A_ INGCODE REGULATIONS DIVISION r1l)I1��'vzv L l
2300 Virginia Menue
Ft.Pierce,FL 34982-5652 OCT :? 0 201y
4 --' 772-4624553 Fait 772-4621578.
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St Lucie County, FL
APPLICATION FOR TEMPORARY USE PERMIT
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BUSINESS NAME:: c Ct' rQ
NAME OF EVENT:. Gc��P _ F(4 k U
LOCATION AND ADDRESS OF T 1 DORY USE EVE"-' __
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PROPERTY TAX IDENTIFICATION#::
DESCRIPTION OF TEMPORARY USE: Vo
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DATES OF THE EVENT:, 60/& 1 16 m n
APPLICANT'S NAME: (4Q,-inn, '
APPLICANT'S STREET ADDRESS
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CITY:Jam- i ei'at P STATE ZIP CODE:
WILL THE EVENT HAVE A TEMPORARY LIQUOR LICENSE;;YES _ NO
WILL THE EVENT HAVE A •TENT s YES
TENT(s): NO (up to.0. square feet exempt from fire permit); X 3:C?
WILL THE HAVE;BANNERSlPENNANTS/FLAGS?YES .._. %NO (Only 1_p'er 300linear feet;32 sq ft max size)
I HEREBY ACKNOWLEDGE THAT THE ABOVE INFORMATION IS CORRECT_AND AGREE TO CONFORM TO
ST.LUCIE COUNTY LAND DEVELOPMENT CODE,SECTION 8.02.021..
R19T APPLICANT'S NAME SIGNATURE. PLIGANT
STATE OFTLORIDA,COUNTY OF mC >
ACKNOWLEDGED BEFORE ME THIS 1`1 DAY OF CQ Q to b er 20 C�_; -
BY I�Cl r (1G uf1 Z--. WHO.IS PERSONALLY KNOWN TOME`,
OR WHO HAS PRODUCED ;,4 : `'. AS IDENTIFICATION.
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SIGNA URE OF'NOTARY TYPE OR PRINT`NAME OF"NrOTARY-
TITLE: NOTARY PUBLIC:
COMMISSION NUMBER:` Fa35
St,00910/19/2015
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EXPIRES J*.Z 2017
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PERMISSION FROM OWNER OF PROPERTY
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DATE: .. ..
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St. Lucie Cai
AS OWNER OF THE FOLLOWINGDESCRIBED PROPERTY 1 AUTHORIZE S
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TO_HOLD A TEMPORARY USE EVENT..
PROPERTY TAX IDENTIFICATION#: --
LEGAL DESCRIPTIONir
OF_PROPERTY „_ p
PROPERTY ADDRESS: . ,
OWNER:INFORMATION:
PROPERTY OWNER'S NAMELCA(lric, d C tt�7P
PROPERTY OWNER' ADDRESS:pYC :
_. STATE., ZIP CODE: Y
PRINT OWNER'S NAME SIG WNER,
STATE OF FLORIDA.COUNTY OF I V`C eGtC
ACKNOWLEDGED BEFORE`ME-:TMS C DAY OF 0016 b w'. - ,ZOIL2 ,
(' mai, V�e. WUQ IS PERSONALLY K -M
NOWN TO E
BY ,"
OR WHO HAS PRODUCED _. ASIDENTIFICATION.
SIGNATURE OF NOTARY TYPE OR;PRINTNAME OF NOTARY
TITLE; NOTARY'PUBLIC COMMISSION NUMBER:1. '5
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