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HomeMy WebLinkAboutBuilding permit appALL APPLICA4LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: J` �5 2v Permit Number: _ Building Permit Application Planning and Development Services / Building and Cade Regulation Division .V!/ 2300 Virginia Avenue, Port Pierce FL 34982 Residential Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT APPLICATION FOR: To Select from droPbox click arrow at the end of line PROP IMPROVEMENT LOCATION* 3 — Address: _ Legal Description: 5 e Lot No. Property Tax ID #: Block No. Site Plan Name: Project Name: Left Side: L1DETA:1L:E�D:':DESCRIPTION cks ront Back: Right Side: OF WORK: � sir�fl neu) 3 fog l�L si,r,R &r , : �j with ioku� teak. )N INFORMATION: - _r Pc a app Y Aaron nm .+�� •� Gas Tank Gas Piping IJ Shutters HVAC klers i SprnGenerator Electric � Plumbing "— So. Ft. of First � "F'l�tic Floor: — Total Sq. Ft of Construction: (_ISe 1 Utilities: Sewer P Cost of Construction: $ A 0%� x State: City: Zip Code: Phone No. e-rvm%'.____---- on next Page (if different Fill in fee simple Title Holder from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice QWindows/Doors ORoof Building Height: Name:Ivu n I company:itr rr fir �!)y i hYlptlA Address -.—")f 06 iU,fllFlliC>L State: F-1— City: rk3 -1—City:o71;<L( 373`1 Zip Code: Fax. 34A iii r S.i rt Phone No. 7 �a E -Mail: CAC,l 1818 Ip State or County Licen e: commencement is its required. SUpp eta'�t;3MN. E�Fj�'v LAW WFO WIATM- I ��fy�NTAL G!y Gktl6YiWM Name: �-aYV6 1<Llti.6U p4 YsF�* xcgo q; p �) ��>F®Q !'l } iif�aCFie Address Lrddess- _—Phone - State:Zip: State: _ Phone FEE r MU HWDEWi Name: Not Applicable Name: _W -Applicable Address' Address City: zip: Phone city: Zip: Phone: i certify €hat no avork or heitaifati©n has commenced {priorta the issuiance of a permit. St. curse eauniv makes no rePreSertfatitxe tiaatis grarriing a perm$wdi autharszetherermi4 holder to fluff d lire subject structure L a =ra �rL �,ftz is t max rrstritX ar urahi6it such ects, perform the work ed } of {.. f i_ f "ereby agree that' "A' 1 L _{ifu LLucieCounty -x[ ei in accordance The t'ML i fences,_ _ _ • Si a !. urilding perort appiecations are exempt from Undergoing a fUR concur-awy revemr room additions, }. x f[ Y wnng S I[_ I- ure },4a t' -t t�{'Y r. i'? iI nt%vas atidruxidefted before me Ofw f / 7 I by is 15LK 1 fi' % Name of e ni Personailly Known )j OR .. .e - fi"rr t ., Type of Identification Produced (Signature Of state of noirift) Notary Public - State of Florida Cly�ommission # GG 017 mm. fres Aug 21, 2 02 1 Rev. 8/2/23 ISM I1 y.r fix t CHRISTINE J. Commission # GG 017839 My Comm. Expires Aug 21, 2020