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HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: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 ¥ `S7€Cin D \ L| L'I - C>D C) - C3 Address: Ill CD)05 \ u= I,-e,,a-Property Tax I D #:Lot NO. New Electrical Meter Second Electrical Meter Additional work to be performed under this permit -check all that apply: Mechanical Gas Tank Gas piping Shutters Windows/Doors Pond Electric Plumbing _ Sprinklers Generator Roof Total Sq. Ft of Construction: Cost of Construction: S L106 Sq. Ft. of First Floor: Pitch Utilities: Sewer _ Septic Building Height: I.:AifeJ:,.'J,~ .;b``r±T`\a!j§'/£<,``uT>`-q`¥rf` `; :^f`<`RE`" `.`"RERE;z§i9€se#8Sasse.SREE%ststsefi.%sasas`xg#ngbREas*sseREasRE.se^S¥asQseti%RERE§se#3%8&aeas%S. ®. -#-a §;#:-:.-?",gjffi 5A©9 !`*:tsa±`:.:.`is#.f4<,`<1 €gr\u;i+.`nga.¥#`.~;BF5fa=ifeF:on4,`,,,¢`+,,I,*yr~>`.,as`,r`N;=e:r'-5c>hy`''froTLLnun` Address: Ltcity:`he Aatlci fro i>y~company: Z5~fi 14rc € CTLt€CLtrcY}P L~. geLaoA^ state:Address: B3Cr ^JL{/ flufaL4P C4:~ City: St\^+Pi4 State: FLzipcode:6Vcnc`Fax:• ..- RE . PhoneNo i+oq- 2,ic3 -caL/ci phoneNo hL-14a4-143ls~ Fi[I in fee ;imple Title Holder on n=xttage ( if different E-Mail n.nL4CLe c p)hffi<#. L`On state orcHnTy'License |' RA, lql lA3lHfrom the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. Applicable MORTGAGE COMPANY: Name: Not Appllcafole Address!State;_ FEE SIMPLE'T}TLE Hot.PER: Name State: Not Applicable OWN ER/ CONTRACTOR BONDING COMPANY: Name: Address: Not Applicable Phone: AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. Tc`e-r-tiiv-that no work or installation has commenced prior to the issuance of 8 pemit. }{piLc:hcj?:?°pc:gn3t9E#c:#n§§,r#hppryF!i:inifgtLfi:5hfgiisfi#s8fi,8gtai3P#eir3Tn:?%#aa£Syr%°#5gtgSfo€#a%#&#ri;%i8nSua:irt#§#3:pffSiytL#b#sruech ::::::g;rnacti°#t3i:i:grpap#j:gd°f#s,rig:S;::fd8eBruffitt{Jgd££eer5€B%da§[::utch{%ttowu'L't#a|}er#m€e¥tts.pefformthew°rk Thefollow}ngbuJld{ngpermitappl!cationsareexemptfroffiundengoingafullconcurrencyreview:rcomadd}tionsy accessorystructtjre§,swimmingpcols,fences,walls,signs,scrgenrcomsandaccessoryusestoanothernon-residentialuse twARNlne To ormffi TouH FAILun T8 REcorm A ueT!cE oF couEH£EME«T May RESLJn rm Your BAYING__..__L __. _-_-Li[---` -,,-- I"-.L --.-- zl..4~ h-~+J'Lb~h JLLlhI+, a,,T,THh ,+,I;,,1,-.Jlt+ell-|-11---~--_ _-_ __ __ . Frm rmFRo"Erms ro TouR psopEfur. A H®TlcE aF coMM€REEMERT HLffl RE REcoftDEp AVP_ ___. _ __ ___-I.t ..--, *|I-|X)A --LIJt±,,I t+-ae -enirml`ID ro ORTAIN ffliARE:twG, cON§uLTiuspEurotwrm oH Tne JOE SITE BEFORE "E flfesT T"€E YOwtt LfflpER OR "rmoRRT BEvettE `i3ture of Owner/as Agent for Owner EEEE". ',-- *`___ Name Of person Personally Knowri _ Type of Identification Produced OR Produced ldentlfication 18nature Of Nota Commission Nofl ic- State of Florid,a B:|fmryKP#Cstatoof Commisorofl GG 28 REVIEWS FRONT COUNTER DATE RECEIVED DATE COMPLETED REVIEW un H®TICE ®F Of Contractor/License Holder Name of person making st8tgment. Personai}y Known Type af iderltlfication Produced OR Produced ldent]ific8tion (Signature of Notary Public-State Of '}#prffo¥rSRE8o?£g#£teT#e9tat8o REVIEW REVIEW VEGETATION fiEVIEW SEATURTLE REVIEW MANGROV`E ftEVIEW