HomeMy WebLinkAboutBuilding Permit Application iII
ALL APPLIC/k6LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. !t Permit Number; q ` L ,�-,
4
hECEIVED
Planning an Development Services Building Permit Application NOV 0 1 2017
Building and ode Regulation Oivislon PERMITTING
2300 Virginif Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone: (77 452-1553 Fax: (772)462-1578 Commercial Residential _
PERMIT A PLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address:
1
Legal Description: I
Property Tax #: Lot No,
Site Plan Na
Block No.
Project Name
Setbacks F nt Back: Right Side: Left Side:
1E r'_1QC_* Q Ick _"A4
w.
Add( I K
t o w , to a er orme un ei is permit—C ec a app y: E
HVAC Gas Tank []Gas Piping _Shutters 4-__!Windows Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft ofstruction: m Sq.Ft. of First Floor:
Cost of Constrrctl'on: $—, Q C� Utilities: Sewer Septic Building Height:
MW A
Name Name:
Address: _!�� Company:
FH err
City: ► S e7 . Address:
Zip Code; Fax: CICy:��` (JUG J` ._ State:
Phone Na. L� Zip Cdde: ��
E-Mail: Phone No.:? ( r 1 (
Fill in fes simp Title Holder on next page(if different E-Mail: U^
from the Own r listed above) State or County License:
If value of const uction is$2500 0r more,a RECORDED Notice of Commencement Is required.
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91>fSldlz MWEI: • Not Appl6ca %Q E COMP,AW: 'Not Appl;IQWe
Name, [dame:
Address: Address.
City; StetB• City: Stdt2:„�
P: hone: — Zip, Phfi►ne` —
FEE SIMPLE NQLDIER. Not Apombl�e ROWNG WMPAANY: ,_Not Applicable
Name Name;.
Address: Address,
City; -
Zip: I Phone, --- Zip, - Phone.
l eertily that n k or ant Mation has commend pride to the ISKwnw aif Y parMPt,
SL Liya o Cou akes no r t: 1 C6ai1 Cha (s rydtin l QrrnlC y�I 41f orlte th0 D cult Adder Ia build d!e b eel. ructsYre
Whk A In twth n� tSpIIc3C�i!tfioa►M1s orirrery A,amt�aelan ryM�,l?ylaw;�r pnd c'rowentlnts else mayl ro�trlcR ar prQh1bIt yireh
3buctued.PJe Wns�d ittt 1 our Kom�e v+�iws A!&w1 Batt a»U rtu4ew Your+44ed for any rest�ktlnn�whlCll maig 3�pply.
is conslderst" of the grantlrd of this rwesud peren�140 hear asrae that I will,In aq respects,oftforM the work
in amordanci vNie ammwed pdaidd,the Florieftl SWIding Vadis and St.I,titie County A Mendments.
The fbikmkfg b Ilding pvorlt appilrations are emamp frnrn undwSaing> 14x11 ewcurrew Maw:roam additions,
aocP&5oty Wix M,twImn rig paaM,fe vmwaU AMtu sman roup ,arid acdessory usfrs to ono"non-rastideiifid uc¢
WARNING T OWNER',Maur failium Us Avord a Nolke 4�Cammi wnsm may ffflwit in voter payi ttwke for
im vemen to your property.A Nance sof Gvmmence ent mast be t>mided,and past+?�d aq Cha jobsite
be the h ins,peUon, It You tend to obtain thane tomult wl lendrer or an$ttnmev before
cam Errcf 6 r Nt><tJee of En qnL
Signa it of a SI ure Bold
STA, F RIDA STA 0� flR113A
coin a cou 0 - --
Tha ftxyofng I frurnent was adf` Madp0l hefora slue 'Me fam6lrig ki"mmt W4s adcr owiedged beinre me
this day 20_ by this day of 20— by
(Mame of pars ackww a ng) (Name of PwW llddio ledgirry i
;)Sl ta►ture af« lary PubpG•State c 6 arida) { 18rlatuna of NoUry Py W skate of Fiodds)
Pwrso uftV tt I/ OR PNKIAr A4 IdVtiM840n Perumllr Mown OR piodmed kdontif wi ibn .. —
Typs at IdemiN Ian PrDduoecf_, Typa of Identlfieesdnn Aroduoeef
commission 07? i' tsaadF CommIF on NO. 7l1���_.eri �a�1 riptYUru
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