HomeMy WebLinkAboutBuilding Permit ApplicationAF APPLICABLE INFO MUST BE COMPLFiED FOR APPLICATiON TO BE ACCEPTED
Permit Number:
Building Permit Application
�r�r•^; ^C� C^d �2vp;oA,ner,: >e�ices
3uriding and Code Recu,atior. Division
230C Virginia Avenue, For: Pierce =L 3448-2
?hone: ?-2(462-1553 max: (772) ^-62-1578 Commercial Residential
PcRM! i A;PPLICATION FOR:
IM
,-.roDer'y Tax IJ-------- ------ _.
Site aian rJan
3acK RigM Side: Left Side:
Sccbscks cr6nt _—
ditTonal work to be pertorme�d ur. .er t is oermit--che& all that apply:
MechaniCa; Gas Tark GjhUTlP. rsas Piping —
-,s, Sorink ers Ge^2rator
CTai Sq. Ft ronstruc6or.: —
SG. `t..0 .-first =i00r:
7j i.ltiiities: Sewe, Septic
Lot No.
Block No.
I✓Vindows/DCOrs Ip
roe -
Building Height: e
.Name:
,� =`,�`�YaQ6�.0:n1pany: i�� ~ '^(��r •"fi$ 7'- iv i <Tt�, '�2'� ii""i
ate address: 005
.,c<<a., 1���- State: r,
�i ?iL Coce. _ � Pax: City: -
tio.�1'�— zip Code: 3Z93 ' -ax: iZl- %�%
l ~� Maij PhOrc No 772 ;. 7-
i cill in fee simple Title Holder on next page ( if different c'. t�aii; c-- S S'�c• ni 0.i'� �" ' o= - �^'' ----- -
{ from the Owner listed above) StBic or : our.ty License:
-- —
�f vaiue of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DES?GNER/ENGINEER:
Na-ne-
Address:
G..,
Phone:
FEE SiMP
Name:
Address.
?!p:
TITLE HOLDER
Phone:
Not Appiica
State.
Not Applicable
MORTGAGE COMPANY
Name:
Address'. _
City:
Zip: Phone:
Not App!icable .
Sta;=
BONDING COMPANY: yNot Applicable
Name:
Address:
i
City:
Zip. Phone:
that no work or. n?siallatior..:' as commence, Orior t0 the issUorl(2 OT c' ?ernl,t
Si. _uc.e County mattes no representacion that i5 granting a! Permit will authorize the perrim `:older to built~ the subject suucrure
which is in conflict with any applicable Home Owners Association rules; bylaws or anti covenants that may res:ricc� or,rohibi-,'Cuch
structure. ?lease consult with your Home Owners Association and review your deed for anv restrictions_ which may appiv.
n consiGe ation of the granting o- :his requested Permit, i do hereby agree tar! will, in all respects, perform. the work
accordance with the approved plans. tale Florida Building Codes and St.:ucie County rnendmen-s.
"he foliowing'buitding oerrnit appiicaticns are exernpt from undergoing a fuii concurrrency review: room additions,
ecceSSory s7r*�—ores, swirnming poo's, fences, walls, signs. screen roorns anci accessory tSses to another non-residential use
WARNING TO OWNER. Your failure to Record a Notice of Commencement may r esult in your paying twice Tor
!rnprover^e I , to your property. A Notice of Commencement must be recorded and posted oilthe jobsite
before the -St inspection,. if you, intend tc obtain financing, ccnsuit with? lender or an attorney before
commencine work or recordino vour Notice of Cemmencemen-t.
✓_]JY aA A -A(% Mk1.ii!`—I-acO Ls;4W
oture Conira.—.cr. _ e.. ? ;older
IISTATE OF FLORID /� �`^, STATE OF FLORIDA
COUNTY OF Q G�COUNTY OF
')+P r�^'•ncmg instru . t was ark^ov:;ed3e^ eicre -,a
`he fvego;r.g inSCry 9'+: —as acknOwleci�eC bQTO * •'^f
r`�;s ��S day cr' 20 .,b:• this lctdav of .20 A by
"YBnt ^f orr�pn acknowiedaing )
ir!%Ps.ure r,' wo;ary `U�SI c• S ae iercP !
't SOr18i!v Know.^. OR Produced !den;ifica.,on ! Persortai:y Known. _- �( yin Pr ` _7�_ oduced identitica,oen
•.;+f, ?"(i e"-rCei%O�r' P O0
�UC9C_ yPe Of Id=nil?i.^ation : oduCed
?r.^scrip:; V LJ �- b1 �✓ see;) LO ;,r 1i�5iOr• V0. 74 ^{
Rv`-1se'j - ?Or��A Expres i ssion 8 02G 152970
;.,, Nb1 PLE?=
11 !NMAI C
34�
Notary Public State Florida
AStVe�r-A4•'+4gICiiBH
My Commission GG 52970
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