HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Build-ing-Permit ApplicationPlanning and Development ServicesByUrfinn nnrl['nria Ranulntinn nivicinn
2300 Virginia Avenue,Fort Pierce FL 34982
II Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential Il
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PROPOSEDAMPROVEMENT LOCATION:
Address: LO341 34457
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Site Plan Name: Block No.
Project Name:
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I(I CONST RUCf ION-INFORMAI I.ON: III
11 Additional work to be rtormed under this permit—check all that apply: it
L-1n vm%- •LJ bas lank "bas Piping. Mai,Liners wii,do'WSIL)oors
Electric Plumbing / OSprinklers Generator Roof �� Roof pitch
Tri+ol Cn C+ref('nne+ru r+i�n• _ _
Cd. C+ r,f Circ+ Cl-:
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City: ✓ y► GC State: Address (p` W Ge'�--
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-Fillin-fee-simple Title-Ftolder-on-next-page-(if different E-Mails Q
from the Owner listed above) State or County License: sL L
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NO3CV r We..01VIN� NCE SENT
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State of Horida.f ounty of St. I ucie
per'.01i ting
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Legal eseription ofprope Ind add ss iTA f available UIk 4 4 Luc;g it Lk 6 l 23 0)
I ItGeneral descriptign of i`n�ove�ents/+ f• •� D --6;066 i
:?lctltlxec b 7,25 V1 Oelee- t Or LA 3Y FL 3 W5
Interest in property: �Wd
Fee Simple Titleholder(if other than owner)
Address ^� /-
Contractor — VI G%A /Q Phone#
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Suety -•!Phony-#
Address i Fax#
Amount of Bond
Lender Phone#
Address 4 Fax#
P`i:i`,'.:iii 19`il liili a i iL314i:i)1 c n:)i�:Ua U:a:Yo ii77tCU 111'1 iii ti s•uiifii3 whom ie�).iCeS r)rt•oiitei•iii)eaoi��ti i>aat.77 Oe.'W!O eii AN 1114 7 V
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i� SCction 7 7., li Io Pida •♦_ftattit:S: U
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Address I Fax# I U o
In addition to himself,owner designates o ' r
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Phone it Fax# ! x '0 N
to rereive n en" of the I innne-�'a,Nnfirp ns nrn'tridarl in Qaetinn 71 i 11 111 thl,Fln-irin CMtntnc Vvnirntinn data of n� U z CS w o
Commenc,,ment is one from the date of recording unless a different date is specified. «rA DV Tr-_TO 011VIN;{ F o o a o
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PAYMENTS UNDER CI-1.713.13,F.S.,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO-Y_OUR_P_ROPERTY. A NO• ui 0 Y o
COMMENCEMENT MUST BE RECbRDED AND POSTED ON THE JOB.SPPE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO� w��0�
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FINANCING, CONSULT WMI YOdR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOI T. O Z a� w
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OSi'nerl LeSSee,or Owner's or Lesse 's �utoortzeti OfncenDirecior�TnrinerJ'rian:egeri Signniure
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natory's Title/Office
State of Florida,County of 0 �i
Acknowledged before me this ,day of eIST 20 ,by(' 1?A'`!6
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Signature of Notary T vne or Print Name of(VTotary ,K„«
IDA VERRELLI
Title:Notary Public Commission Number ,,vgA pUd Notary Public,State of Florida "
_ Commission#GG 93737
My comm.expires Apr.12,2021
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