HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABTE INFO MUST BE COMPLETED FOR APPLICATTON TO BE ACCEPTED
Date:Permit Number:
Building Permit Application
Commercial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED I MPROVEMENT LOCATION:
Plonning and Development Services
Building and Code Regulation Division
B0A Virginiq Avenue, Fort Pierce FL 34982
Phone: {7721 462-1553 Fax: (772) 462-7578 Residential Y
Address:
Legal Description:
m-r Lot No. 7
a-
Block No. IJ
Property Tax lD #:
Site Plan Namel
Project Name:
Setbacks Front Back:
-
Right Side:Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION :
Re-Roor 5h;"91e 1o 5h;nilR'
,Jndrrtqln1cn* tuoe * /L tl'tO{- R'{ '
Shinglt-
^roA # rs.re tt.io -finnnko
Electric
Total Sq. Ft of Construction:
Tr
luid-Shles Arp4o,l
i'ler;fagg $';n1ttS
Gas Tank
Plumbingu [_lsprint<ters
cost of Construction ,S 2, /OO.*u
I *,noo*s/Doors
E*oo, W Roorpitch
Sq. F of First Floori
-
Utilities; I lr"*", I lseptic Building Height:
Shutters
Generator
ffiormo'e,aRECoRDEDNoticeofCommencementisrequired.
CONTRACTOR:OWNERILESSEE:
Name: /dchac I &aq-
Company: lk/zhe/ R/te Rorla tnt ' -
Address: 3{ < rsfr/t flt^r
city: /e/? 6rac4 F/ state: S-
Zip Code: 32 ?62. Faxl
Phone No.'r?2- /af -t Sty'
State or County License:
City:
Ph one r,r o.*t fJ-:5 3Q:E-14
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
xare'. fL
SuPFLrsfrrHTAL calusr&ufils&tr *rs lssj rN$sell*&Tls{,
FEE stfiAplE ?tT["E FiO[,sEE: ## r*"t appGUia ESSOISiG CSfttpAISy: W$otAppticable
ow$re/ {o{tITRACro* AFFIHflT: Apprkation is hereby ntade t* oht.in *
I certify that *o werk or installation has ccrnr*enccd pricr to ihe issuance of a permit
i'ltfii-fiffiH,&'-ffii.!f;i3lif1ir.l,fff'fis,iBtl:,Fi"litg,xgtffi1,tf1.,#i,i%1t.tffi$rf,s$1tf,";fl,9gojffi,f,iiiTir..,,structure. Please consuh w'ith-iariittomiow;d;As*;;iffi;iliirdi6il'6[o']L*d f., uny restr3crircns dhich may appry.
lil c6&sid€ratis,r of the gra*ting *f this reguested Fermry. I d* hereby agree that t lyi l, in all respec6, perforrn tire tvor&in accsrdasrce with tlre approted plans, thr rtarigi auilding c"ao *nair. L"ii*-iou*ty n*."n6oorra*
The fatlorving building permit applications are exempt fr*m undergoing a full crncurrenay reviesr rso$l additisns,acces5ory $rugtl,lres. swinraing pocls, fu*ce*, walla si*ns, screen fi,ornr and accessary uses tg aeother non r€sidefitial use
wAAHl't€ ?S Otf,Iltffi: Yourfaituretr 8*srda $o,t*cE of Comfteftefilent rrlayrmlltin yourparyirgtx$ce forimprovements to vour proPgrty. A Notice of Cornmencernent must be recarded and postea iJn-tfielJuiitebefore the first inspectfun. lf ydu intend toortain iini*ilg;'il;ii*;tilenulroril;ii;mei Gi#;- -t
cqnrygftqing Wstk gF#datdingyou!' t*otice of Comrnenceil.trt-- - R
Rev" 8/2J17
$TATEST FLSffOA
causxw ar ai*i ;/- rvie, s
-
The forgoing instruinent was acknowledged before me
this /? dayot th),u.L _ .zal{W
Name of, perso* maklng statement
Perscnally Kntwn rf O& Pmduced ldertiicsti$n
?ype sf iderltifita{on
Sigrat*re of ContlEctcr/Lice*se llolder
STATE OF FISB;DAecuurvcr"-Ju;.i *a,-r* _
Personally Knorrn - r,/ " OR Produced ldentification
Type of tCenU'ncatffi**
l**rnr ef person maleirg stateme*t
I(AII{.E€Xt,VALE'?*XI
liyCOl*ra6SS. lpFlr"lti2