HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 11 -LI ZD Permit Number:
Building Permit Application
Planning and Development Services
Building and lode 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: 11101]
Legal Description:
Property Tax ID #: '�� ^ 0025- 00 5 Lot No.
Site Plan Name: Block No_
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be ne nrme un t r
UHVAC LJ Gas Tank (_LJJGas Piping LShutters
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Electric 1—( Plumbing Sprinklers Generator
Total Sq. Ft of Construction:, �' AT --
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Cost of Construction: $ i U/JU, W
S�F"tt.� of First Floor: _
Utilities: LJSewer Septic
QWindows/Doors
ORoof
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name WI /'q T�n C.
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Name:
Address: 3�`� �.
Company:
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City: ' D State:
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Zip Code: 330 (0q Fax:
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Zip Cade: 3 41 5)
PhoneNo.— %�- L(p(-!114-J
State:_
Fax: -71.7-- 0 -.373-7
E -Mail:
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State or County Licen3e:
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{Signature a:Public- S'�te of Etar'.da }
Commission No. HRISTI M NWELL
FEE Si � HOLDER; � iif€xt Agpficab€e
E31Nfi C4i�PAplY': Applicable
-£{N}I$TINE J. C L
Name:
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+ •; Commission # GG 017839
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OVM 'TRACT€ R Vi T: Application is hereby made to obtain a pe mrtto der the work and installation as indcated-
i certify that no work or installation has commenced prior to the issuance of a permit
St Lucie Got%t��y m-aks no representation that is granting a perinitwifl authorise the pee, -nit holder to iwdd the sub{ett s¢ucivre
wrhich is'cn ro, ct with any applicable Home owners Askdation rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consultWM Your Home Owners Association and review yrriirdeeri for any restrictions which may apply.
In consideration of the granting of this requested permit trio hereby agree that i will, in all respects, perform the work
in accordance with the: approved plans,the Florida Budding Codes and St rude County Amendments -
The following building permit applications are exempt from undergoing a full r�ncurrency review: room additions,
accessory structures, swimming pants, renes, walls, sIgns, screen rooms and accessory uses to another oon rest ent-at use
OWNER:WARNING TO Yew Why to Record a notice urs Com r.W resuft in €�rrt twice for
hnProvernents to your prope=rty. A NOtfce Of Commencement must be recorded and posted on the jobsite
before the first inspection- if you intend to obtain finandrig, consult ftf t tender of an attorney before
commencingwork or recordingyour Notice of Commencement
COMPLETED
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Rev.9121 7
Signature o` CAarner( L�seejCanisaetar Agent far hva�
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Commission No. HRISTI M NWELL
Commission 6-
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Notary Public -Stats-0l Florida
-£{N}I$TINE J. C L
Notary Public -State of Florida
Signature o` CAarner( L�seejCanisaetar Agent far hva�
Signature o.`£orr�ac¢or/license Holder
STATE OF FLORIDA �• (f t pi
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STATE OF FLORIDA
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{Signature a:Public- S'�te of Etar'.da }
Commission No. HRISTI M NWELL
Commission 6-
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Notary Public -Stats-0l Florida
-£{N}I$TINE J. C L
' •_ Commission # GG 017839
Notary Public -State of Florida
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+ •; Commission # GG 017839
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RECEIVED
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COMPLETED