HomeMy WebLinkAboutBuilding Permit Application1 Ll 30
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z Permit Number:
Building PerMit Application
Planning and Development Services
SuRding and Code Regulation Division
23I0 l rrginfn Avenue, Fort pierce FL 34M2
Phone;(772)462-1553 Fax:(772)462-IS78 Commercial Residential
PERMFTTYPE:
Address:
Property Tax ID
Site Plan !dame:
Project Name:
OF WORK:
INFORMATION:
00
Additio�Jnalworktobe performed under this permit -check all that apply:
=tvechanical _ Gas Tank _ Gas Piping I Shutters
E ectric _ Plumbing _ Sprinklers d Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor _
Cost of Construction: $ 21 . 25,3.��7 Utilities: _Sewer _Septic
Lot No,-] �
Block No. ZS—
_ Windom/Doors
_Roof .Phch
Building Helght:
OWNE_R/I.E5SEE:
CONTRACTOR:
Name 2 ✓ fr
Name' r
Addreis:.r771i
ComPanV: r
Oty: t::�J-irl P✓[� State:_
Zip Code:,, fi tL Fox:
Phone No. ��-7-Z�i ' �/3 S!
Address: i mn,,i,
City: _t . .,,-„-t state.
Zip Code: Fax:
Phone NO
E-Mail:
Fill In fee simple Title Holder on nett page (H different
from the Owner listed above )
E-Mail yr ' k ck + ��
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State or County License Gam( ��.a -,(-j, 6
.......cmcr.renc is mquneo.
If value of HVAC is $7,560 or more, a RECORDED Notice of Commencement is requlred.
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
Address:
City
rip: Phone:
MORTGAGECOMPARN: _NotApplitable
Name:
Address:
City. state:
Zip: Phone:
BONDING
City:
Zip: Phone:
IVIT: Application is hereby made to obtain a permit to do the work and Installation as Indicated..
has commenced Prior to the I900nce of a permit.
gtlon thaLts grentmg a permit wRi authorize the permit holder to build the sublest structure
In consideration or the grarttlng of this requested permit, I do hereby agree that I will, in all respects, perform the worn
In accordance with the approved plans, the Florida Building Codes and St. Lude County Amendments.
The following building permit applications are exempt from undergoing a full comurrencp review: mom additions,
accessory structures, swimming pools, fences, walls, signs, screen roams and accessory uses to another non-residential use
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COUNTY OF �Vl `r
Tha to7. nil Instrume t was adcn edged before me
this..2U l
The f�brgoing Instrument as achrwwledged befo; a me
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Name ofp nn mplafts statement.
Norha or, person making Petemant.
Perso Known_„/ _ OR Produced Idenftitatian
no K X OR Produced Identification
of tlon
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Types 1 'cation
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Ronald ouchalls
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED.
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