HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I1 I N I 1 1 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division /
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Legal Description:
Property Tax ID #: `' l(r�.� �d �0-(,li Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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With 5 KW M tt -
CONSTRLICTION INFORMATION
L_vJHVAC LJ Gas Tank LJGas
11 Electric 0 Plumbing OSpr
Total Sq. Ft of Construction:
Cost of Construction: $ 3ooa. 00
Piping U_ Shutters
nklers Generator
_ S Ft. of First Floor: _
Utilities: —Sewer Septic
Windows/Doors
Roof
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Address:
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Company:y7��i7 Ci!( �1ZQVIJFi%A NQ_ C(�jyj�.
City: ?1Yu- Stater
Zip Code: ;L�Q 5 ( Fax:
Phone No. Z-7a - a,Q 3- IlQ L
Address:5fO A Tt l7l0i(k9.
City: 1'fl rlr I f e.(Ce�, State: RG
Zip Code: `3 41,5 +11 Fax: -1'%�' L(&/Q-373-1
PhoneNo.-`(g-- LK-Af-414-1
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: �j,Agal2P qq j 00. CO (1 1
State or County License: CAC 18181 3
it vame of construction is $Z5W or more, a RECORDED Notice of Commencement is required.
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Name:
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Address:
Address-
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Zip: Phone
Stale:
Ctty:
Zip- Phone:
State-
FEES 'fSFtE
Name:
� ,fiSot Aggaiicaiste
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llot Applicable
Address:
Address:
City:
City:
Zip: Phone:
T_rp: Fhone:
LAW t1YMERj CONTRACTOR �DVIT: Application is !to eby madeto obtain a permit to do the work am installation as indicated_
I certi%r thatno work or'snslaFtation has commenced prior to the issuance of a permit
St. facie C�a� kes no representation thatisgFaniing z perr,�xviH authorize the . holderto build flte subject structure
' whine is in with any applicable Home Owners Association rules, bylaws or and counts that may restrict or prohibit such
structure- Please consult with your Horne Owners Association and review your deed for my restrictions which may apply -
In consideration of the gcdn�gaf thts requested permit,1 do hereby agree that I will, in all respects, .per€orm the work
in accordance with the appr-d pWl%the Florida sadlding Codes and St iueee County Amendments.
i The following building permit applications are exempt from undergoing a full concur=.ency review: room additions, 1
accessory structures, swimming pouts, fend wails, s semen rooms and accessory uses to another norvresidential use
WARNING TO i_R: Yaw failure to Record a Notice of erst imay result in your - twice for
improvements to your property- A Notice of Commencement merit he recorded and posted on the johsite
before the first inspection- if you intend to obtain financing, consult With lender or an attorney before
comment ' work or reeordin your Notice of Commencemerrt_
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SUPPLEMENTAL CONSTRUCTION
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STATE OF FLORIDA
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