Loading...
HomeMy WebLinkAboutBuilding PermitALL APPVoI /B► �• INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 4i ��l cdl Permit Number: 5 - rJ_ s Building Permit Application Planning and Development Services Building and Cade Regulation Division 2300 Virginia Avenue, Fort Pierce Ft 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 fMPROVEMENT LOCATION: Address: (L( 4 Q3 Legal Description: Property Tax ID It Site Plan Name: Lot No. Project Name: Block No. Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Li lc>c dor Lila : )vls+cL(1 3 i�v� Rc�u D l l S Er? C Pack Lwin IV6 (o to heat. IN INFORMATION: o -- orme L.LjnVAL L--1Gas Tank 6a! Electric Q Plumbing OSP, Total Sq. Ft of Construction: Cost of Construction: $ _ 3lf' OWNER/LESSEEf Address: City: Zip Code: Phone No Piping L_(Shutters nklers U Generator S Ft. of First Floor: _ Utilities:Sewer Septic State:R, Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Qwindows/Doors 0 Roof Building Height: Name: A&'-,hQrLI AA{� Company: 30V/01- AU i'l(iF�r�41fo/, c City: Mf t� 1`7 efc& State: f=tL Zip Code: 3 �fq5 i Fax: -71.1--1(b(0 -373®7 Phone No. - -414-1 E -Mail: State or County Licen e: Chi(,' IS IS 1$ (p of construction is $2SW or more, a RECORDED Notice of Commencement is required. Name: Address: City: State - Zip: Ph©ne PEE P1ETME [+Int Applicable hiarene: Address: cam= Zip: Phone_-. R+itiR76AGE ARY Not Applicable Address-: cftF= State: Tap: Phone: _• ' WARY; _Not Applicable — -a- H sra n a ss a•- - s. nr. it er-. x q' -e which isinwrrii-€t#iia' ai'sR%ta tori tl�rnzersLeis�PenrlMu:aumornethep:�mitnsi€derioinn tinesubjec€structure structure- Please conscrtt- t`itx y Homemoaners AssQcra V atl aeas oral=ouenan€s tray restrict or probe 1; such yaurdeed for any rest€ictionswhich army, apply - !n considerationof the grantirg of this retfuesaed perrok t do hereby agree that l will, in all respects, perform the work in accordance with the approved planS, the Florida EuMng Codes and St: Luce County Amendments. The e #oNauang building permit applications are aeemptfrom undergoing a full concurrency, review: room addstions accessory structures, swimnirrg groats, (graces, walls, ssgns, seen roams and accessory uses to anor}rer noniessidential use WARNING TO Q -YOUrfalftrre to Record a ROOM Of Corrtrnel2mmerid may result in your paykg twice for improvements to your property_ A Notice Of i Dramencement must be recorded and posted on the before the first inspection. nse r If youaintend o obtain fina€t€in& CMSUit WM lender or an attorney before site __ _ ____ c sae evsarsefCt6i.CrrrerrL //�j//� Srgnature 0NnerJ ae Rgent =or aaer sign -tore ai Coatractoducense Holder �rCo-ntr�a�ctor(/f STATE F 3. 1 �3 �/I• I.VWlit Tc.�aSc OF �Q €, e}a STATECOUNTY Ct3l.IiVTY �%F VV�lll The forgoing instrument w2sacknowle acknowledged thts�dayef_J_U,r1L The frngoingInstrument was acknavtledged before me 26_ by thisj4-dayof r1 Zi?2D6y E+ chest F. fe. Mic lei Boyle, Name rrf tement PersonaU�Knouvn 14 OR Proeduced lderttifica€ion Name of pers aking stn ment Personally Known OR Produced rdentitu au. Type of IdentificationType of Identification Produc/ed�� Produced (Signal trUL_ of -c- State o€Rod da} (S-knature€t#Notary is State ofMorida} COn3rOt590n fl: d'r• r IiHRIoTINE J. LL Cbmmessron NA Notary Public - State of Florida v°y ,>�e,, CHRISTINE J. ELL - . • Commission # GG 017839 c Notary Public -StFlorida v o: y o m. Expires Aug , 2 20 REVIEWS "°f1 onded I Not y } c ° es jA 1EW IiMEW R alio DATE RECEIVED DATE COMPLETED tev 8Iz11� __