HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST ESE COIMPLETED FOR APPLICATION TO BE ACCEPTED
Date_
I1 a -
0
i 6 l
Planning Gad DevefoprmntServices
Permit Number:
Building Permit Application
Building and Code RegufarlooD rsron Commercial residential -(
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax. (772) 462-I578
P�R�u11T APPLICATION FOR: IN STALL IMPACT SGD-(REMOVE AND REPLAC; E)
J�R OPOSED IMPROVEMENT LOCATION.
Address, 7420 LAURELS PLACE -PSL FL 34986
3 2-501-0010-000-1
Property Tax I0 #� _ Lot No-1
Site Plan Narne. A L L E N&K I M ROSE IN y A
ROEN Block No -
Project Name,---
DETAILED DESCRIPTION OF WORK:
GTE
( POO KET 4 PANEL} CNV SACK PATIO
New Electrical Meter _ _— Second Electrical Meter
RUCTION INFORMATION:
Additional work to he performed under this permit —check all that apply:
Mechanical
Electric
Gas Tank
Plumbing
Total Sq, I=t of Construction: _
Cost of Construction: $ 4I-00
Gas Piping
Sprinklers
Shutters
Gencrator
SQ- Ft. of First Floor:
Windows/Doors Pond
__ Roof Pitch
Utilities. —Sewer —Septic Suildirig Height-,
OWNER/ LESSEE- CONTRACTOR-
_j4ameA 7' N ill OIV— - SON FF _WKNF__
Name:
Address; narD I
City: P State: '
Zip Code: Fax;
Phone No-
E-Mail,A
Fill in fee simple Title Holder on next page ( if different
from the Owner Jisted above}
compony:
Address: 1T7 U=WANN-
City: HUT fI� [.ANC state;
Zip Cod94'5 fax:
Phone No77 -0166
E-Mail Ol TES � I�
*State orCcuri y u cense
If value o€Construction is 251]D or mole. 8 RECORDED" Nottoe of COMmencenxvnt is roquired-
IfWWI? of H AVC h $7,SW or rnore, a RECORDED Notice of Commencement is required.
DE S FCSNERfi—N—;lNEER - N t
�
City: State:
Zip- -- Phone
FEE ISVIPEE TITLE FIOLiIER: TUot Applicable
Name:
Address:
City:
zip:
MU GAGE COPOPANY: Not AppJicabJe
Name:
Address:
City_v. State:
Zip: Phone:
BONDING COMPANY: hiot A - —pp I"—hIe
Name:
A�dres5-
�--
rp: Phone�
OWN FRI CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indatated.
I certify that no work or instaJfation has oammernc, �d prior to the issuance of a permit-
St- ii� n¢confli❑# uvitt� a rly app rI cabie IHo a Ow granting
� Assoc permit
rules, I]ylaws or and �pveJ7holdant:s tr t malt' rthe Su estrict bject
prohibit re
structure. Please consu ft wrtFr your Home Owners A LWIelation and reef ew your deed for any restrictfons which may app Fysuch
-
In consideration of Ike geariking of this regu red emit. I do hereby agree that I will, in aff respects, perform the work
in acccudanpe_3wFtfh the approved plans, the Fiorida Building Codes and St- LuF-iFL County Amendments -
The foklowing building permit applIcations are exempt from uridergofng a full concurrency review: room additions,
accessory structures, swimming pools, fences, wafis, signs, screen roorns and aoressory uses to another non-residential use
WARNING TO OYMER: Your fallure.to Recarcl a Notice of Commencement May result in
improvernents to yofJr property. r�l Notice of Commencement must be recorded arpd posteuT Paying he+jobs to
before the first inspection_ if you intend to obtain financing, consult with lender or an attorney before
commencing work or recordin Our Notice Of Carr mencement
Sig re of Owner see/Contractor as ggent fat owner Sign r"e o€ Cor4x-Fat use I Icrl(i
STATE of
GaMM
The forgoing instru errs was acknowledged tefom me
the ay of r 2 by
(Name of person acknowfed in
{Signature of Notary Public -State of Fk
Personally Known —OR Produced identificat�on
Type of Identi{icatio
Produced '1 t— .
Commission No_
ApRIAHA UYA
4Dtery Pubk- State of FIc
wltomrnission # GG 46a&2
.My Comm- E7tlire5 Noy 7
er
The forgoing irkstrurr� t was a�knc}wlet# ey�d b efore fne
this��day of— � y
Name of person acknomledgi rig }
C gnaturfof Nat�ry Public -State of Flo )
Personally mown--- — OR Produced Identification i---
TEype of IdentificE or,_ 4a
No -
REVIEWS FRONT ZONING, SUPERVISOR PLANS VEGETATION
COUNTED REVIEW RF IEW REVIEW REVIEW
RECEIVED
I A1TE
COMPLETED