HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE CO PLETED FOR APPLICA71ON TO BE ACCEPTED
Date- Permit Number.
COUNTY
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34992
Phone: (77Z) 4b2-1553 Fax: (772) 452.1578 Commercial Residential
PERMIT AC
chon u+ blte
P ORP POSED IMPROVEMENT LOCATION: }
Address: =0d
Property Tax ID #:Site Plan Name:
Project Name:
CONSTRUCTION INFORMATION:
Add iti al work to be performed under this permit �- check all that apply:
Zechanical _ Gas Tank _ Gas Piping _ Shutters
— Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Constructions $ utilities: —Sewer Septic
Lot No. ----
Block No. ---1 -
Windows/Doors
Roof Pitch
Building Height: __
OWNER/LESSEE: CONTRACTOR, --
Name Name: 0
Address: Company: in
City: I State: Address:
Zip Code: Fax; City: State:f ` -
Phone No. Zip Cade: Fax;
E-Mail: Phone No 4 -
Fill in fee simple Title Holder on next page ( if different E-Mail 0 e
From the Owner listed above) j State or County License
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
AL M
r
SUPPLEWENTALCQNSTRUCTION LIEN LAIN INFORNIAT
OES1GIyERIENrrhlr�r,. ION;
' Name: — .L4`� Not Applicable
Address:
MORTGAGE COMP le ,V
ANY:
City:
Name: Not APPlicab
Zip:
phone State:
Address:
City:
FEE SI --- ----
SIMPLE TITLE
Zip: Phone: State:--
e:
Ha DELDEL R. --- —
Name: Not Applicable
__
BONDING COMPANY: �-
Address'.
Name: Applicah el
City:
zip:
—Not
Address:
L
City:
y:
OWNS Rf CON I RACTOR ——
Zip: Phone: _.
AFF'DVI7
certify that no work or installation has re
camrnlenced priarto b he
L County
`untYconflict
— —
the work and installation as indilr`
issuance toobtain
of perit to do
permit,
w , s
which is in
makes no representation that is granting a permit
with o applicable structure. Please consult with
pp (cable Horne owners Association
will authorize the ermit holder structure.
rules, bylavis or and wild
covenan th the subject
may restrict or prohibit `�u:,I
your Home Owners Association and review your deed for any restriction
In consideration of the granting
of this requested permit I do hereb
in accordance with th
a ree tha l Ali which may apply
e approved plans, the Florida Buildj T F� W , In all ing Codes and 5t. Lurie t[ County Amend ens' perform the work
The fallawirlg building permit a gents-
pplications are exempt from undergoing a full concurrency review: Loo
,accessory
ssory structures, swimming pools, fences, walls, signs, screen rooms and accessoryuses to another n
m additions �
""DARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY on -residential use
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCfIgENT RESULT IN YOUR I�;"'
POSTED ON THE Jog SITE BEFORE THE FIRST INSPECTION- IF YOU INTEND TO MUST BE RECOiIDI=�; f
-. 1YPfH YOUR LE ATFORIIEY BEFORE RECORDING YOUR MO O OBTAIN FINANCING, Cr%
- __ _ b_MMENCEMEaIT."
Signat of Owner/ Lesse /Contractor as Agent for Owner
Signature of Contractor/ icense No er
STATE OF FLORIDA
COUNTY OF
The or ing ins t t%askn❑wledg efore me
this day of 20-L. by
Name of person making statement.
Personally Known OR produced Identification
Type of Identification
'Produced
(I�H Q 0 �m EkLEaLALMa
(Signature of Notary Public- State of Florida)
I Commission
I 'REVIEWS
RECEIVED
COMPLETED
ASHLEE M BELTRAMENA
Wr M%WW10N d s,ea
EXPIRES July 22,209
STATE OF FLORIDA
COUNTY CIF
- c
The r Ding instru t as acknowledge efore me
this day of 24 rby
Name of person making st ernent,
Personally Known OR Produced Identification
Type of Identification --
Produced-_ c r�yr
twl�:
(Signature of Notar P at EL ;6AELTRANENA
'� LeyComm ION1xFrggQ�Bfl Commission No, EXPrRE�l22. 24 8
COUNTER I REVIEW 5 REVIEW QR I REVIEW VEGETATION RE IEI+U S REVIEW i � �VIIkW