HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 21 Zo Permit Number:
Building Permit Application
Planning and Development Services
Building and Code 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 IMPROVEMENTLOCATtaN:
Address:
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:_
Setbacks Front,
r
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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Pad( aAl umifi U7ifYI Id Kw hee-
Lot No.
Block No.
CONSTRUCTION INFORMATION: III
I I Gas Tank UGas Piping
El Plumbing ❑Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ T, UUUa �U
Shutters 11 windows/Doors
Generator E] Roof
So'
Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
OWNER/LESSEE?
CONTRACTOR:
Name hh
Name:t¢D
Address , S DP� I�tOi%E
Company:BGIQ Ul ffla ";
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city: IF,If( _ State:('r/
Zip Code: qs Fax:
Phone No.-:�17.- 0252 (p�
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Address:.5/�(d pr-Ft(f1Pt��t�{.Li?
City: fbrib IlE,fC& State: r -L
Zip Code: S 415 e d t3 30_a t I, Fax: -71.7---
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Phone No. I- -4111
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: (Y
_
State or County Liken e:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEIVIENITALCONSTRUCnON UEN LAW [I R AT(ON_
DESIGNERIENGINIM
Name:
_NrstAPPEcaW
MORTGAGE ANY _NotAltplkabie
Name:
Address:
Address:
Ctty:
Zip: Phone
State: _
r State:
Zip: Phone -
FEE SIMPLE111 :
Name:
_ Not Appficable
BO COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip.• Phone:
£1p: Phone -
t : x,.r M
r . - 1
In consideration of ihe granting of this requested permit, i do €tereby agreeihat f will, in all respects, perform tare work
in accordance with the approved plans. the Ronda fhwld tg Codes and Sr- turte County Amendments.
The frolloven building permit applicabons are exemptfrom Lnde.�ng a full cmmurency revu-w: room additions,
accessory structures, swimming pools, fiences, walls,srgrts, saeen moms and accessory cases to anon non-nmilemiaf use
WARNING TO OWNER: Your, t'ailvre to Remrd a Notice of CommiInceitientrray result in you paying tutice for
improvements to your property- A Notice of Commencement mast be recorded and hosted on the jobsite
before the first inspection- If you intend to obtain finandng consult -:lith tender or an attorney before
/ 4a .
SANE OF FLOR eDASTATE OF FLORIDA -{
COUNTYOF �• COUITIYOF Jl , ei
The for dmwas�aowkAgedmei
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{Acta . &v (e.
Name of persat tement
PersonatiyKrsawn OR Produced&lentilicabon
Type of identifimtion
Produced
state of Florida }
CHRISTINE J. YELL
Diary PubliC - State of Florida
Commission # GG 017839
REVIEWS
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Thein g - m was acknowte�gil before me
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PersorKnown Uat Pa xdtaed identification
Type of Identification
Notary Pubk - State da
— Gommlesion # GG'OY41
My Comm. Expires Aug 21, 2020
Bonded through National Notary Assn.