HomeMy WebLinkAboutBuilding Permit ApplicationOWNER/ CONTRACIOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated'
I certify tirat no work or installation has commenced prior to the issuance of a permit'
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structure. Please consult
ln consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the ,ppiorEJpi."i, itt" rfotiai Building Codes and St' Lucie County Amendments'
STATE OF F
The forgo
this \O
ins instrument was acknowledgq(before me
aa-v ot (I.dOOee . zo lEi nv
Name of Person making statement
Personally Known Jr.. OR Produced ldentification
(Signature of Notary Public- State
Commission
: OCI 28,2018
BONDED T}IRU$T TLORIDA NOTABYIJ.c
Type of ldentification
/ Lessee/Contractor as Agent for Owner
knowledgg! before me
-
2oll5 by
Name of Pgrson making statement
Personally KnownL- OR Produced ldentification
Type of ldentification
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PLANS
REVIEW
Rev.8l2lL7
FO MUST BE COMPLETED FOR APPLICATTON TO BE ACCEPTED
ALL APqr[cAPLE- l{ Fq M Usr BE
;lDIfDlls Permit Number:
Building Permit APPlication
Planning and Development Services
Building and Code Regulotion Division
2300 Virginia Avenue, Fort Pierce FL 34982
prronu' ittz) +az-ts53 Fax: (7721 462-1578 Commercial
-
Residential K,
Address:
Legal 1 )-
I
*, *o.13
Property Tax lD #:
Block No. \ tZ
Site Plan Name:
Project Name:
permrt -aoDlv:
E ro.
l-l Ele.t.i.
Gas Tank
Plumbing
I-ln", Piping Shutters
Generator
[l *,noo*s/Doors
u_nsprinklers tr l_l norr E Roorpitch
Total Sq. Ft of Construcfolt:So. Ft. of First FIoor:
Utilities: [_lru*"r. Et"*Cost of Construction' $3S Building Height:
Setbacks Front- Back:
-
Right Side:
It vaiue of construction is $2500 or more, a RECORDED Notice of Commencement is required.
PERMIT APPtICATION FoR: To Select from dropbox' click arrow at the end of line
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Company: I
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E-Mail;
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Phone Uo
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)