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Building permit app
ALL APPU LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Z % Permit Number: s q Building Permit Application Planning and Development Services Building and Code 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 IMPROVEMENT LOCATION: Address t>1 X40 I c7rCti �fi i17(k �l L(f Q �_ f _3Li�SS I Legal Description: SVA 15H I i VJ5 1(LUQ►Ai) - KI le- Ill ✓ i n+- -7!2 Property Tax ID #: Do. 0115__ 000 pi Site Plan Name: Project Name: Setbacks Front Back: Right Side: Leff Side: Lot No. Block No. AILED DESCRIPTION OF WORK: 1-:1 nsfk1 ntw Lennox 4 Loh i 16 SEEr- Act�l�oT A � stisle(m JI Skw bae� uf head. TRUCTION INFORMATION:' na war to ,ewe Orme u❑ ert uoermm-� o� � . ,..__:.: (; LJHVAtr I _j Gas Tank uGasPiping UShutters 11 Electric plumbing Sprinklers Generator Windows/Doors O I=1 Roof Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ ly�(J� OO Utilities: Sewer ❑Septic Building Height: OWNER/LESSEE CQNTRACTO1, City: f,' t Ttlfce, State: fi� Zip Code: Fax: Phone No. ;L 110 Fill in fee simple Title Halder on next page ( if different from the Owner listed above) Name: NIi�CzV1`L"C �4 (SticGIP Company: 30 lg� Ai%(1��j� — P J yj�U -a . Address:3106 A _YJM ik9- P? fd } PYL I City: MFS (7{ erc& State: Zip Code: 3 4q 5 i Fax: —71-7-- 4&0-373-1 Phone No.-I"l E -Mail: lGl1 lJ 0- t State or County Licensle: CAC 18 IS 13 (p of construction is $2500 or more, a RECORDED Notice of Commencement is required. Address: city: Zip-- Phone: Address: City' State: Zip- Phone: BONDING CO : NotAppicable Address: ZiP. Phone_ ermit holde€to build the subject structure covenants that may restrict or prohibit such In consideration of granting ofthis x -. - _ -- --- •� rPstrict4tlnswiv i may apply. In accordance to th of requested permit, . do herebY agree that I will, in all respects, perform the work ap.rro'� Plans Ae Hctrii 8ta n9 Cads and st. Luce CountyAmendments, The folfowing iafiidiM pemut aPPlitations are exempt frown uddergtring a full accessory stmt lures, swimming pooh fences, walls, ' ��` review rain additsons, s rss, saaan rooms and accessory uses to another non-restdanjal use WARNING To Your (Moire to Record a Notice of Conirtence-meat tat3g re5csli in vstor fsayst� take for improvements to your Ply- A Notice of Cornmertcement must € rt riled ons# Ssssted ssn the obslte commencingbefoy`hefirst inspection, if you intend to obtain fsrsart[rstg consutt==rith lender or an attorney tsefsrra work or recusdine vnur htntr Q ^t r:a�,,, n , __—Fore• Ow I `C.!? 5igttaiure tie°tiwnerl rnntra ��- AgMf fiir STATE OFORIDt3i St - The COUNTYOF IJ I f The forgoingIrtstrulPentwas acknowledgedbefore me ihisAA-day CR—,� 20%0 by W,haeA F &M (e. Name of gerson Waking sthement a!!y Persou#nown V©k Prc�uced Jdertil#i�liort Type of identification Produced ioMRIiSS-= ina''P�a�, CHRISTINE J.p ELL ry-Public - SYa't`e`li'lorida • : : • Commission # GG 017t39 REVIEV45 l-V1Yl8lER t REVIEW Rev. 813117 t. J rb2%�rr��outg ins metti was acimawiedged before me this 24t daytaf�,Ln 2i32o by Wtic6fl f:� & `k, Name of perso akmg stat4ment Pea r©n'Ji' IG own OR Produced tdenification Type of tdena6retzon Pr/o/duu/]cceddu,,, ///�/�/� �- CHRISTINE J. UNWELL cam : Owl Notary Public - Stag Aida missiod# GG 017839 �F, n. Expires Auy 21. 2020 i gp�r y� �qg�/��g YE Li! -t 2l ��yyy �. X 1-1 iLTFt\4LL y�p�ypy�t'i'LilY3 YYIH}Y�tlifYREEVIEW REVIEiNREVIEW REVIEW