HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 �d �� Permit Number. �$�� 7@,13
,-.:,^ s.• RECEIVED
Building Permit Application ����
Planning and Development Services ® ���
Building and Code Regulation Division ST, Lucie County, ittfn
23W Virginia Avenue,Fort Pierce FL 34982 P 9
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line S S
PROPOSED IMPROVEMENT LOCATION _
Address: 6 Q
Legal Description: /01 p, C� �4_kjQ sOC cShac,/4 I Yt 6(& 3
Z--f YL t— 1'0 `I�Q 6A
- &14 ; c5
Property Tax ID M.
6 6 -' d �(0 1 C)U6 Lot No.
Site Plan Name: c� L � '` Block No.
—T
:Project Name:
Setbacks Front Back Right:Sidev Left Side:
PE�4i�OESCRIPTION,:OF WORK
CONg UCT1ON IIVFORNIATIQN '
Additional work toe e orme un ert is permit-c ec a y:app
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing OSprinklers I Generator 1:1 Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor.
a
Cost of Construction:$ r� 5� Utilities:USewer R Septic Building Height:
OWNER/LESSEE _ CONTRACTOR:
Name Will1 Gia:irr--+ LVerQ Name: C¢ C
Address•. v Company: r wVL-
ciity: Iz -State: FL-, Address': Z 03 if CJ
Zip Code:.3 COl�1 Fax: City: Ff t State:�C-
Phone No. Zip Code:3'f'76'>- - Fax: 7 7 A-Ww1 f-7V
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: cz (2e� �0
from the Owner listed above) State or Coun License:
IF value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
s
DESIG GtNEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name: _I__
Address: Address:
1y: State:__^_r_ Crty1 State:
•`rrp: Picone: Zip:.. Phone:
FEE SIMM Tt1'LE HOLDEtiw- '_ Not Appflcable BONDING U)MPANY: Not Aplpllcable
Name: Name:
Address: - Address -
+ Ckr. -
Phone:
Zrp: Ptww
1 a vtft that no work or butalaDa has awrunamd pd w to the lm mm of a permit
to rept n3atap�1 mit th
ould theUp���
such
struatumPhan=nsutHEimHome OwnersAadree�d �rt'—l —MM io b
10*ftmaltao*.
In amsideration of the granting of"requested permit;i do hereb juV e:drat i w1%in all respells,perform the work
in awardancevath tWappmved plamthepiorkha&OftCoftwWSt:LucleCountyAme tdments.
7heftowin8'ln&ft waft appiiaaV=veexvwfwm wrdery ftafr v eonwrren v review:room additions
amemy structurrrs swlmming PWL%fences waft sis,scr"ea"mand aamssury uses to ancthm non4tsidertW use
WARNKS TO OWNER:Yawfallme to board a Nance of Q I U-no 11"t may result In Vaur,e-—v ft twine for
i,=emerds to your prDperty.A Notice of Commencement must be recorded and posbed on the Jobsite
• before the first Inspection.If you intend to obtain floagdng<consult with lender or an attorney befiore
comancing work or recordinsE vour Notice of Commencement.
�/ 1 S€grrahae of Cha? Holder.
STATE OF RMDA STATE,OFA
t30ti'IItIYOF��- 1..W�-fie OOUNT1i0l
lbe 'ighouame{L as l dge 'an lbefbr ---VNMAYIl{e1s4 M'MY4Y.. YGty.Qi 4
d>�1sLday of �J\j , 20 b this \ 0-day of 6�N-P � by
(Name ofpersm — } ��.�•.—"'�"" �Nameof adtnow
{SlgnahaeofNotary lto-Slate ofFkdda} {S n uffeof state ofFiadda)
PAY Kwm Ott Produc ed kation Perso URV Khwam OR Iderrt;licaRlon ;
Type of MattiBodanProduced �. -I�pe of IderrtiRaation --NNA MARIE GIVENS
-- _ '? MY COMMISSION#€GG 022423
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