HomeMy WebLinkAboutBuilding Permit ApplicationkAdd
4
ii$ Ci A : application is rradeto obtain a perrr�ito dothe work and ea .tion as tndsralbed_
l certify thatno work or Installations has commenced prior to the issuancia of a permit
SL Lucie Countyurakesnoragresentationstiatisomatuigapm.ni`twiiisuthor'stet3izpmTiiholdertobuildthesubjectstructure
which "s in gi with any Horde Owners Ass eux toles, bylaws o: as to rearlsihat restrict or prohibit such
structure_vleaseconsult iTowmoueOwners Asso ration FerreKryour deed for any � tonsmituchmayapply,
in consideration of the granting of this requested perrni; t do hereby agree that 2101111, in all respells, perform the work
in accordance cath the approl pians lbe Florida S ffiffing Codes and St.. Lucre CruaFity A€=.iendments
The fallowing building pem3it applications are exempt from i ndergo ; a full rnncurrerit+d reutiew; room additions
accessory structures. svmvmirig pools, feria, walls, signs, screen rx3oms and accessory us�to another non-residential use
WARMNG TO fl y to Record a me r' r result in fray€reg ice for
improvements to Yam' property. A Notice cif Commencement must be recorded and posted on the}obsite
l before the first ham. if you intend to obtain f nan€in& consult Frith tender or an atiorney before a
ecrrrerriertian work or recoea Notice of Cornmeneement �
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Rev_ 812/17
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WiaiaaeoffviifFactor/Licenseitolder
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SignaturersfUrunerfLcsseelConiracmr Ageritfor
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S'i$ FLORIDA
OF
SEE FLORIDA
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iriE'Fi3rgailg HiSrriiriEnt Was acimauAedged befIIFe me
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ttii5�'t�day of.2ft Ya by
anis 27*day of-Ac0r1T��T Zi} 26 by
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Name of peFsmi - -- - -
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type of tcrerifii;raaiun
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{Signatui:.afF NWELL
+P°acE Notary Publicof Florida
:°.
CHRISTINE J. CONWELL
tary
State of
3 f'
=�: • 0 Commission # GG 017839
kAdd
4
ii$ Ci A : application is rradeto obtain a perrr�ito dothe work and ea .tion as tndsralbed_
l certify thatno work or Installations has commenced prior to the issuancia of a permit
SL Lucie Countyurakesnoragresentationstiatisomatuigapm.ni`twiiisuthor'stet3izpmTiiholdertobuildthesubjectstructure
which "s in gi with any Horde Owners Ass eux toles, bylaws o: as to rearlsihat restrict or prohibit such
structure_vleaseconsult iTowmoueOwners Asso ration FerreKryour deed for any � tonsmituchmayapply,
in consideration of the granting of this requested perrni; t do hereby agree that 2101111, in all respells, perform the work
in accordance cath the approl pians lbe Florida S ffiffing Codes and St.. Lucre CruaFity A€=.iendments
The fallowing building pem3it applications are exempt from i ndergo ; a full rnncurrerit+d reutiew; room additions
accessory structures. svmvmirig pools, feria, walls, signs, screen rx3oms and accessory us�to another non-residential use
WARMNG TO fl y to Record a me r' r result in fray€reg ice for
improvements to Yam' property. A Notice cif Commencement must be recorded and posted on the}obsite
l before the first ham. if you intend to obtain f nan€in& consult Frith tender or an atiorney before a
ecrrrerriertian work or recoea Notice of Cornmeneement �
i
IeF 3
l
3
Rev_ 812/17
' f - � 3 � a. _X ,a ` d t 9i: t - l ' r �i•, i' i '. '. b .. # { C i '
I
li
! Phone:
WiaiaaeoffviifFactor/Licenseitolder
5
SignaturersfUrunerfLcsseelConiracmr Ageritfor
r
S'i$ FLORIDA
OF
SEE FLORIDA
Ct?3lNiYflF Sfi�
C:oS:N'SY�� � LUClPJ
iriE'Fi3rgailg HiSrriiriEnt Was acimauAedged befIIFe me
The foFgCif6g>#t5rriameiStllL>•dS 2LknawEEdgELr before me
ttii5�'t�day of.2ft Ya by
anis 27*day of-Ac0r1T��T Zi} 26 by
�'f Fr,�,1 �V1�
ic6e(F & lc�
Name of peFsmi - -- - -
� prodi�ad klentificaron
Name of - "
Personally Known i}€i Produced edantifrcation
Personally Known
Tyne of ldentificataan
type of tcrerifii;raaiun
Produced
Fradirced
r
i_�VaLCJ �iIr�:�%u�C/`""
�S Y
{Signatui:.afF NWELL
+P°acE Notary Publicof Florida
:°.
CHRISTINE J. CONWELL
Cotoriissan N ommisslon(g�jp17839
tary
State of
0' M Comm. Expires Aug 21, 2020
=�: • 0 Commission # GG 017839
Bonded through National Notary Assn.
My Comm. Expires Aug 21, 2020 -
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DATE
REEEi�IH3
DATE
COi19PLETED
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `Z� 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:
Address: 4 "
Legal Description:
Property Tax ID #: 23D3- 241 - 002-5- OOO 1,5 Lot No.
Site Pian Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION' OF WORK:
U(( -Fo( UVt . %siol 3 ton(2u u D 14 S e e IE A(C Rtdca�. unit
toil 10 K head.
CONSTRUCTION INFORMATION:
iti a war to (eve orme un er is permit- c e a app y: (�(
Tank ❑Gas Piping Shutters (�_(I Windows/Doors
VAC f I Gas _
—H
11 Electric 0 Plumbing Sprinklers U Generator Roo€
Total Sq. Ft of Construction:: W.00S Ft. of First Floor:
F]
Cost of Construction: S "i l Utilities:n Sewer Septic Building Height:
QWNERAESSEE:
CONTRACTOR:
Name5 l CS �•
Name:
Company: i , t . � r*
.
Addr:gs: 1 Q •
City, f1'tpQiYlb r2Q il, State: rt,
Address:5106O--YtMI(U( 15.E
City: fbr& Rtfc& State: r-t.
Zip Code q Fax:
Phone No.+eflh*: $d) la yfIQS
Zip Code: S 0 5611 Fax: -77;��p-1( -373`7
E-Mail: 595- 961 -a�i8�l
"
Phone No.-g- Of-41*I
Fill in fee simple Title Holder on next page (if different
E-Mail:
State or County Licen e: i.A-C 18 I S 1
from the Owner listed above)
If value of construction is S25W or more, a RECORDED Notice of Commencement is required.