HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Perm.!! Number.
Hare:
?'onrrna and Development x V;Ces
3ui7dina and Code Reauiation Division
2300 Virginia Avenue, Fort Pierce 34982
Phone: (772)A62 -15S3 Pax (772)A62-1>78
PERMIT APPLICATION FOR:
h
Building Permit Application
r-mercial Re-sidential
Address:
Legal Description:rsyo�-w cor
yi �� Ay I ILe &u �t�o n�c��lwLa �Uu
n r��-�1 _ �2�� Lot No
PropefCy Tax 0 #: 1 Ute` �J1--1_-`J —
Block No.
Site ?Ian Name:��=--
project Name. --. ---
Setbacks Front
Back Right Siae-eft Side:
i n4al
drhona wo to e performed unoerrms pc!im - --
Shutters ✓�
Mechanical _Gas Tank _Gas P -pi ng ,,Vlndows;Dc)oss
— —
I� c
Electric _ Plumbing — Spnnk.-r_ _ Generator Roo'—
Total Sq. �* o? Construction:
Cost of Construction: 5
Sci Pi. of FirST -1Uor
Utilities_ Sewer _ Septic
City_i n�\IVU State:,
Zip C�: �Q�S� Faxll1A
Phone No.
E -Mail: r� 1 --
Fill in fee simple Title Holder on nexi page ( if different
I. from the Owner listed above]
Building Height.
Nome
Coanpany n r Ei7Z -za ixcuv9 �� =9e
Address: 006 -ry haw6 D . —
�nd<an �ia�r`>ae i�e>ch State:
Gty: I
Zip Code ZGg37 Pax- 77- uZ!
PhoneNo772 5.57-4170
_-------
Sra_e or ou^.t LlCense
If value of construction is 2500 or more, a RECORDED Notice of Commencement is reauired.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not �4pplicabie
Name: Name:
Address: Address:
City: state: City: Sia*e:
I Zip: Phone: Zip: Phore:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name. Name: _ -------- -
Address: _. _ Acloress
City: ❑ty:
Zip: Phone: Zip ?hone
certify than no work or Installation has commences prior to the :sscance of a percut.
SL _ude Coon�.. makes no repres n ��ion Thar .aping m:? will cFor_e r pe,nt : ��u c ba r obi u ire.
which! it confii , with an aDohic bi: Home Own ociat:on rules 5 v ora d w ria'That:may e i or o oh of ,!cn
structure. Please consult with your Home Owners AcodCla t0 and evi_w your deed for anv ret cnons which m.•: aPri
in consideration the granting or this request _d peg mit, ! do hereby g _e ;hat ! will ,�, all re - o pe6orrn -he worn
in accordance with the approved Plans, the %lida Building Codes arc St_ Lucie Couoty Amendment.
The following building permit apPlicar loris are ex rmpt f om cndeceoingail cont ncv rev yr mom ado ions.
accessory structures, swimm
ing pool_, fences, walls signs, s leen rod _s Trio acce story mases t e her se
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice *o:
improvements to your property. A. Notice of Commencement must be r --o-de-' and cooled en the jobsite
before the first inspection. if you intend _c obtain financing cen,su!t wrtr lender or an attol before
commencin work or recor in yo r Notice cf Cemme^ceme
_ Signature of Owner/ Lessee; Agent �,gno w: e o. Co a�,o, ice..-� noloe.
l STATE OF FLSTATE OF FL IDA
COUNTY OF YYP�IC�YI� _ COUNTY OFii
a- --
The forgoing instrunenc was eckro, eo<=1dG rh1 'o e_lm� In rm.a wleaaea zro=e r�
this da, , _ '_0 (� be
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Co n Noco, ass - -- BROOKE
BROOKESZIGETI
MY COMMISSION 0 FF 244666
My COMMISSION#FF_244655_ ``
_EXPIR — --. —
I S: June 25,2019 -- —__--- dP`' EB'JBne�S�2am
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