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HomeMy WebLinkAboutBuilding Permit Application ALL " • MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED •. r. ive SII • _ ■ • Application Planning and Development Services Building • / CodeRegulationi 2300 VirginiaAvenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential ''r"fETr"•tts j ti?o- _..i. *,i r F.{a ^- A j-y.' 4 �1i+,. :-.b�..+n,.1.}.a""u..1.�w•.cn.':11,�f�,°7GW`:TLvL,11.,.nr.:r.S,-.?o4,.,,.,evrSu,+fn�x.iFf..v��t,.r.w,v7n[•,�f.„��,r„�r.2.Al11,II'-Lf uly:st'i/4r'_'a1 t`'}•�'`A^�%:,;...A`?..,x.C'C«j.a�,.,,,;.Se�1 trd7.n-e+I�}-,�:.<,:f!'y:>�'- ,r�€,.K.�7N.5•.:".,.1..,.7Lyl,1-t.3,t•+�_:#•�z�ti,'{{+J.�.t,.}f>I3-ii' h.KIlo4,y:�'fza..f•t+"�•t[J�i? nl7k�",.6f rf,,':r.'zfirfn1�'{'{"dTwt}a,.atfltJft.,l?{)K ffrryma.t„�{f`�-ia�1.1r'.{Ia1'rrVS1'”tJ.}{.�»i�1tf�4t1 i�,..1�kr•,.f tl ar.t.r.`J!,tr• :,� �f� ��4 �!� rtJ• 1. •a 211�r�x �U F.,':lA l.L«# ,.ra dd rt S;e:aJ:1 ..Sb.0 ^r.G la.}�::=✓4a.Z!c- ,U,�l�,a_Nh lr...„;e r.lx:uFG.IaL.. ,. 1 Il.'+{ L" u.nd?r �i:u,�.• ,-sr Address: A Legal Description:. 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Fill in fee simple Title Holder on next page(if different, from the Owner listed above) If value of construction Is r • i ' / 0, or more,a RECORDED Notice of Commencement is required. + a n DESIGNER/ENGINEER: Not Applicable iV ORTGA�� GtaiVtl�A�lY: i�at Applicable Marne: -- - Name: Add-ress: Address: City. City: . zip.- q •.... i zip: Phgt�e: EE al /PE TITLE HOLDER; Not Applicable BONDING COMPANY, —Not Applicable 1 i Marne: i wnf:: Address: Address: City. phone;. .. Zip: I certify that no.work pr installation has commenced prior to the issuance of a permit. &t, e Countyy retakes no representation that is granting a permit will @uthgrixe the iprrrit holder to build the subject s>fi}z�ure structure.iA.�lon lc t with wlYh pfiteF�lp Hgttte ownerx Fs�gctatian rules,bylaws 91 pt ran ..Cp�renart�s that mRY re tr(et ar prohsbst such /,�ttr fdpme C3wners Associattsan and reYipY•{your defid e arty r rl tspns w4�t tpY €2€�iY in consider6tion of the granting of this requested permit,I dos hereby agree that i will,in all respect�,perform the work in accordance with the approved plans,ttie Fiorlda Puilding Codes and St.Luefe county Amendments, The following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,femes,walls,signs,screen roams and accessory uses to another ncm-rgsident(al use WARNING TO OWNER;Your fiiat€'e to Record;t Noire QtCer; menegmertt mey resilplq in Vin ��a�grag twine for irnprAvements to your pr opertyj A Notice of Cgrnmerrct mQnt rnt.:st be rec6rded and posted on the job;ite before- first inspeCtibri. If yoo int:6nd to obtain financing,corssult with lender or an attorne before rarnmencing work or recording your Notice of Carrzrt�enmment. Signa Qs:j•t ,5Sa /, gartt i n ' n bstq'rj�! 'she C lsiRr STAT�OF FLORIDA STATE OF FLPR i he farQaing instrument was aGknak+rledged before me The fargoitig lnstrutnent Ftas acknpwiedged before me this'd`�day of :J t 20 t�,7 ,by this 42J day pf �u 1 . ,.-..-�-r 20 by 1 (t ante o pas son acltrte+infledgin (l imoV pgrsan�Skno�vled in `} _.�..,- .,ter--r-.. .�-.�.�.,---..,r..�Y..•r .�;.L {5sgrtpture Q Nota! �?yhtiti-Ski€e jric igi� turezf 13it puli � t fib�ids l 1 Parsanally Known OR Produced idenxifipatign� Personally Knpwn�—�OR Produced►dentifi[atlon 1 Type of,Identification Prcrdu ed Type t7#ler+tifi+ratlgn Frgduced.,, ,-, """'Q - GENA LORENZ RU . l trot yr PuDbFC-9Ate of Florida HE1'RUF ' Comm(ss�on FF 057967 i %�,= Notary public 5 i tate of Florida ,r My Comm.l<itpic'a eb 7: - grig MY Comm.Expires Feb 7,2020 { 41rv1 IEM FRfi�IyT z�;3NING 5UFVRVl$0R RIAI�i �f it�iA�l i i SEA eller rL l�",AiVixitt if G 1iNzIR REVIEW REVIEW REVIEW RWIEW � REVIEW REVIF-W COMPLETE INITIALS