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HomeMy WebLinkAboutBuilding Permit Application (2) J APPLICABLE INFO MUST BE COMPLETED FOR.APPLICATION TO BE-ACCEPTED i /ate• Permit Number: Building Permit Application Planning and Development Services i Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential 1 PERMIT APPLICATION FOR: P ' To Select from dro box, click arrow at the end Of,line POPOSE'D IMPROVEMEN^T 4LnaCATION Address: . 5 5e C2cS�l�rt le(, 17�>Y�� 10c.ie R, �J�fc 3 Legal Description:9y yW&- wit 5 1::K b � '-� brmu 1 A2", MN Property Tax ID#: � "I Y )'�l o Lot No. -691 ` Site Plan Name: Block No. Project Name: " Setbacks Front Back:_)Right Side: 0 Left Side: Y DEl'AILED DESGRIPTfON OExWORK � �..��� �WNPN With (o fbofi 5th _J C©NSTRUC710t INFO:RMA"�'ION � _ < �� „ _ . Additional work to p e performed under this permit-check all t=apply: HVAC LJ Gas Tank Gas,Piping _Shutters a Windows/Doors Electric 0 Plumbing ❑Sprinklers Generator Roof Roof pitch Total Sq.Ft of Construction: S .Ft.of First Floor: Cost of Construction: Utilities. Sewer. Septic Building Height: 01�1/NR/ ESSEEt Yh � CQNTRACTOR` 'Name 2 Name: Address: UJ f/ y 121 Vd 3W 3 3 Company: 5C__�.W�3 C .� r City: •}etfi0? State:,EL,., -Zip Code: 19t 333 1-1 Fax: City: Phone No. Zip Code:3���0 Fax: i E-Mail:( i`(�)lSJ"I(�V1SrLi✓Y) oG9lY1GPl�.c(7�y/ Phone No. `1 `a Fill in fee simple Title Holder on next page(if different E-Mail: _ from the Owner listed above) State or County License: ' r ' I If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. ; i fl ,'�k s ;C '.i'1�ih' r .y��( ,. ♦ + ll� �YSi'-'-er i, __—.._.. .-P4 �.___. 1 • i.. - .- .v t.. ; ;. ,`• •. ^ ... "%,'r:'. _.i� _ .... � •'l!-1 Vit: .n_ -. ._ _ - ,_ .—._ �w.v e....._...,_..hJi.c.Fw,,.ti _ �.-..�. e. �� `�i .y;t-a ri i.c. •' ,e» __ .....-.. _ ._. „ ,. _..-. o. ;.>s._..-'--' I `CSS.•4D�?c")'ti. .. ..e._..- . -.--,. .� � ,,- '�— ii ..-•'K . w�< �' , M - � .. _. i.`{��;;E'- J '3IYI,�yr tt...::lr���f>i.. .L � 'f+t;l 'i _i.=�,�• ! � t_;7.a.>,.' � - -_. ._._ -J^'°" 'Ef .-i!' :fr ,i`it',S!,:, _ ._,,.-„,-..... n. _._. .. , }�. '`,K,,,'r��i<,�`� +ii-`.i�� - .~S'�;t.SS,•{:�• .,�Spi, fi .y•�.'i:•; ”' _'' �; • _ s Z� .t LA ij .-._-_ "`^"' _- ---•--•.,_�. _ .a.. ._ _.-:.y_. 71; own In t� l: UPPLEMENTA[.COI SSC I N tli:�l Alio iNf i IfATit?N i * DESjGHER/ENI:iiNEEFis _ Not Applicable WRTGAGE COMPANY: �N✓ t Applicable ;Name:. Name: Address : Adafress: Clay: State, _ City: << State. . ;Zip: PhonesZ► Phone• Z1 - FEESIMPLE TTtE HOLDER: Not Appiicabie BONDING COMPANY; Not Applicable. Name: Narrte•. I '"` Address: Address: - f, t City: Crty: Zip: Phones 73p; Phone: ,.; I certify.that no work or-installation has commenced prior to the fssuance'of a permit: wt:Ducie Counts+niakeUna repres tatfan that, granting a rmlt tt authOrlxethe, drmit holder to build the subjects uture. i fl e Y h this in,ton Ict w any appika le:Hame Owners Assoc aattion rues;la aws or an covenants that=may restrict or pro ibitsuch structure:Please consult wrtfi yourHome Owners Also dation and revteuu your deed.for any iestrlctfurr '.whlch!may apply: f to consideration ofthb granting of this requested pennit,f do hereby agree that 1 will,in all respects,perform the work In accordance with.the approved plans,the Florida Building Codes and St.!Ursa taunty Amendments. The folf6vAng building permit applications are exempt from undergoin a full concurrenq review-rogo additions, accessorytuuswirming Odolees,wails,sin,scrooms uer nonesidential useso WARNINGTO OWNER:Yotnr!°atlurt to Recc►rd of htatFce of Crsrntne:tcemerrt mayrasult Inryour paying twiice fol':; impprovements tt�ypur pr.'operty.A Notice of Cammencetnent must W recorded andiposted bh thd1bbMte before the first irispectton If you intend'to ol5taln finariciri ,cdnsuit W1th Iencler or an!attorney befd crimrraencin =ut_nrkorrecc dio riurNcticuf'Cortimeticernent_ re r "Slgnatureaf0 Ener/lasses Crrntrat ar.`as-Agent•for< Yrier." igri pf.,Cuntrac oC Lfcerse'H0Ider ; STATE OF FLORIDA �.• of * '' STATI-OF FLORIDA COUNTYO .___ - - �, 'COUNTY-OF.. The.fa of instruinen was acknowledged•before me The for oln insfrument was acknof�rledgei�befare'me tlils,�1 d4017!0 aaf 2ojZby }iilS, daY'of.. 3 {Name"of crson acknowSedging) � {Name of personacknauitedging 1;,.i _ MY�M•�r < � \ ,l�l�'G�t1� (Signature of Notary Public-State of Flarlda} (Signature of Notary Public State if Florida.'' Personally lfnawn:. OR.Produced Identification Personally Known " OR Pru luced Identification Type of tderitiflcatlonroduce fi Type of Identification Produced {.: ' s+1 �, Gammission Not "� f lary 3alg aI Asititla �. tS� 'Commission'No.g, , w Com�rrtss t 13£ i3 0, PV STELLA M.BUNTER - Lly Comm.explr 11tf0.28,2ole .. ' ' ,;Commission FF-180552 Revised 071.W2014 • j - +i�gFOF4� O� h�P comm!Expires Jan 23,2019 REVIEWS . ' FRONT -jONING 'UPERVISCIR '•`PIAN$ VEGETATION SEA LE MANGROVE ' COUNTER REVIEW - REV[EW- ::REVlt 1N. REVIEW x!REVlE1N 'REVIEW COMPI:M r.r INITIALS I i