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INFQMUST\b BE COMPLETED FOR APPLICATION TO BE
Permit
Building Permit APPIi
Plonning and Development Services
Building and Code Regulation Division
2300 Virginio Avenue, Fort Pierce FL 34982
phonu, llzl qoz-ts53 Fax: (77 2) 462-L57 8 Commercial
Address:
Legal DescriPtion:
PropertY Tax lD #:
Site Plan Name:
Project Name:
Setbacks Front-Back:
-
Right Side:
-
Left
F.IJ ICNi S ER.rr
IDLN
\rYe frv tir-e Zifi
wo under this permlt -
AC l lGasTank Gas Piping Shutter
Electric [l Ptumuins Isprlnkters tr
Total Sq. Ft of Constructlon:
-
Sq. F\ of First F
costof Construction' s (nil Utitities: Er"*"rf
lf value ol construction is 52500 or mgre, a RECORDED Notice of Commencement
at the end of linepgnur APPLICATION FoR: To select from dropbox' click
l_l noot l-| Roorpitch
Building Height:
State:T I
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Company;
Zip Code:
Phone N
State or Co
citv' ffi{ &trf* t [ALA€- st.te,
Zip Code:*,nZt' l -211L -
Fax:-
Phone N".:a1Z - ?iaz" 5,19 5 b
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
t ao,n" work and installation as indicated'
,TJL:ff igti,:?L:1i":!etJ,TF""i'iii;il1t".h
any restrictions which maY aPPIY'
in all resPects, Perform the work
review: room additions,
uies to another non-residential use
mav result in Your PaYing twice for
=io'rOea and bostdd on the-jobsite
h lender or an attorneY before
ornrnrenlcorwRAcToRAFFlDVIT:Applicationisherebymadetoobtaina
Icertifythatnoworkorinstallationhascommencedpriortotheissuanceofapt
il'fffifu!;.HY,:T:ttlili:ffi,spus#!#Hhlff',!#,s,"ifltl.+iHHi#Jjiti'i:-":;
ln consideration of the granting of this requested.permit, ldo hereby agreethat lwi
in accordance with the "ppr""EJ
p["i, the Floridi Building Codes and st' Lucie cou
The following building permit applications are exempt from undergoing a full
".."ttoav stitctures,-swimming pools, fences, walls, signs' screen rooms and
WARNING TO OWNER: Your failure to Record a Notice of commencemen'
imnrovements to vori-plop'".ty. INoti.e of Commencement must be'#il;" ;h;li; l;Jp".ti;n.ii v,i, i ntend to obta in fi n anci ng, consult wi
ur Notice of Commencementcommencing work or recordi
Rev.8/21L7
ANYt
-
Not APPlicableMORTGAGE CO
ANY,
-Not
APPticableBONDINGNot ApPlicableFEE SIMPLE TITLE HOLDER:
actor/License Holder
was acknowledged before meil4bU - 20i8, bv
Derson makine statement' ><- OR Produced ldentification
ti*
.- Catherine Konger
!--=C@igion#FF7723T?
STATE OF
COUNTY OF
The foreoine i
this \U- day of
Personally
Type of lde
Produced
(Signat/re of
Commission
/ Lessee/Contractor as Agent for Owner
STATE OF
(Signature of Notary Public-I(onger
p.-i Cpuqission # Ff fi 237 2
fo=5 Exp-lres: OCt 28, 20 18
SEA TURTLE
REVIEW
MANGROVE
REVIEW
FRONT
COUNTER
COMPLETED