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building Permit Application
ALL APPLIC LE INFO UST BE COMPLETED F)R APPLICATION TO BE ACCEPTED Date: D �I I r1 g Permit Number: Planningan DevelopmentServlces Build'flalg Permit Application Building and ode Regulatlon Division 2300 Virgini, Avenue, Fort Pierce FL 34982 Phone: (77 462-1553 Fax: (772) 462-1578 '' COmm2rClal PERMITA PLICATION FOR: Residential_ To Selectjfrom dropbox, click arrow at the end of line Address: Legal Desctip on: �1UG v1r A Cli Property Tax q: `3y as-��- o )) } ;uLL-,� Site Plan Na L No, 1 } i' Project Name el ck No. Setbacks F nt 'y Back: Right Side: �a 4 - Left Side: , B, II,�it „• 1119,na w to e'er ormer un ert ispermI -c ec a ..VAC aPP C Gas Tank jj��""�� ❑Ga;' Piping _Shutters OElectric Plumbing n Windows/D ors TotalSq, Ft of onstructlon: USplinklers Generator I� Roof Cost of Constr ction: $ S Ft. of First Floor: `IdCC,6' Utllitles:�SewerSeptic Building Heig Name f\4eS i c 11� Address: a i' Name: {� rI3"Ns 1. City: Company: P L - pany: Vv a StaIIe: i_ 7 CC — Zip Code: yg 7 Address: (©1I) ,� , Fax: � f>I Phone No, City:_ �SL_ E-Mail: ZIP Code. Fax: tate: .�72- Fill in fee slurp a Taitle Holder on next Phone No. -7 - ybl� Page( (ff dl rarent from the Own r listed above) E MaII:M )or o' bgy y State or County License: C C If value of cons[ uctlon Is $2500 or more, a RECORDE.i „Notice of Commencement Is required. ' I i I Name: "Wprrrate MORTr3AGE CAMPgNY: Not Appll ble Address:_ I Naltie, city, Address. ZiP: Stater Ph i one: I4 --- State Zip: Phtute: FEE 81NIPLE jT HOLDER: Not Applitible 9QNDINd EQ—MP Name: I _Not Applic 1e Address: _ Name: City: I Address: Zip: I Phone: city: zlp� Phone; Icertdvthstn korinstedlatlpnlws St. L s co commenced prior to the Iswance of a permR. q Nn ekes noreprosaAyC6on tha fs graMingl ermltwI� wfilctlIs In can with any ®pPlirapia ugrwlesthe�serndt hold to buUd the )eit u lure skructure. P107 egnsuftwith yqurtiom qrs gya�ns�sa s�r sAs--11 t hs E ur,q ra cmnAnt*,i�&Q ay et or Nr Incenslderati afthegrinungofthis r ycurrMldPferanyreatrktfona,wh plm touch In aererdane" ' the appreved pl guested ' tde h�Yagraethat I � y:npiY. ens the Plorfda atdld) codes and St, Lucte Ce� fool respects, perform the work The follow1ng61C:inSPermitapailcotlnnsare a tyAmendments. eceesserystruc rw, swlrnning Pool1, fe ;m undergrdngafiil ccnswrrwwy revlaw: room additions, WARNING T OWNERtiYour folio m "l z screen room'andaemssory usato anottcer non-residential use Am ovemen to our' o Roc°r I a' atke of CommantxmsRtt may rttsult In our a be the ff ins o petty. A Notice of mmence ont must be recorded Y P Yine tw 1 e f r oom encin pe+tlnn, l� yotr tend to ob in firiltncE consult wk lender orarpstt mev hainoh to din r,Natice OffLxnman a RIUqj Hold jA CCQU O OF' RIBA C D The this aing l this 3i y8ad ?�da trumen wasaet M6elota true , dam` 20 by -------------- 7lia i n;itty}fumentuac npwledgad6eforeme thltyof. (Name Pers )� �• (Nsane of permit adatowledging ) i8rsstureaf laryPuhpc StateafFior[da)" �' ! �'r' fg �- futeture of NMIry P Hc• State ctFlorido I Perswta uY K TyPeof IdentfN ' ! ✓ OR Pfodssced Itlan Ion Prodvmd fin. — Per;p 41(nown__ Oft Produced Wantlikation CornmltCion rk j Q% j i f`f � iyPa cf ldaittiffeattan Produced ---�^--- Iseaii.. ' *N4WB TlEri .1DN commission NO; e C, b 7l/4 y at a$!x:'•� g&TwE rQfl ikeyls6d071 + W2014 �j E7ffiNS;may if.= �Plll t!d111J1FYael�etT'Sfj'SIrIfM f)PIgEQ a Mir nrt M21 � . as REVIEWS FRONT COt1NTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION sEAT{11iTLE MAN Rot DATE REVIEW REVIEW R tEyy COMPLETE INITIALS