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HomeMy WebLinkAboutBuilding permit appLLL APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1911 W Permit Number: ,..., Ka- m Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34981 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III PROPOSED IMPROVEMENT LOCATION: Address: I & Legal Description: reel 16 Property Tax ID#: b05- 02-10^0iiU"I Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: LVI�Y, �' (�k� - 3 ion l(n s�>:r; nvwx svl4_ � C Wi 10KW CONSTRUCTION INFORMATION: Ad rti a wor](toneherrormed under tispermit-check all that apply; _ HVAC Gas Tank ❑Gas Piping _ Shutters a Windows/Doors Electric 0 Plumbing Sprinklers 1:1Generator Roof Total Sq. Ft of Construction: rr^ S Ft. of First Floor: Cost of Construction: $ �W oo •w Utilities: 0Septic Building Height: OWNERAESSEE: CONTRACTOR: Name i Name: KaL14 Address:a!L $�(p Ri bISL((r. Company: �) y1gF_ At(- QjVI�I� &yf#,l,la ' City: l' I71Uy(t- Stater Zip Code: 31AlFax: L Phone No. 2 - � b5 _p gal Address:50i% n 1PnJMU rT!'l� . f �P1�2at rye City: fo(br f efc& Zip Code: S 0 51 Phone No.-M- Ong(-41+1 State: F�L Fax: 779- 4&% -373i E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail:6\/IPDA a v/n �no - 0-1) (VI State or County License: CAV'91 *8I8 tD n vaiue or Construction is 4, suu or more, a K[CURUGU Nonce of commencement is required. t fT. I■ eft �I � i '' i a. �" '.: k + a .. r t'. • :1 ,) ,.. i E: .. 4 ' f t -R; i ` t T f s a I Ci €Rf CMIR Application is haneby madetrt obtain a permi€to dotine workam! installation as indicated. i certify thatno work or installiati©rs hascommenced ed priorto the issuance of a permit. Si t a'r+e County rmfl reprPsertiation that isgrantirog a Pew' wilf autiiariae �hotderto hind ihesubdect structure which is in with any applicable Home Owners s§D iado ° rt�. 6yiaws ar t cants that may. restrict or prohibit such rasstR structure. Please Cowith yaw Home Owners Association and reyww your- deed for any restrictions which nay apply. in consideration of the granting of this requested permit t do hereby agree that! will, in all respects, perform the work in accordance with the approved Vans. the Florida Building codes and St- Lucie county Amendmerim The following building permit applications are exempt from €mdergoing a full mnam envy review room additions, accessory structures, smsaming pouts, fences, waits, spas, screen rooms and accessory uses to another non4esidentiai use WARNING To a your €allure to Record a Klordess of Cossurnericerareert araay rendt€n yor r payhW raiee for improvements to your properly. A No -Lice of Commencement. must be recorded and posted on the jobsite before the frost inspection. If you intend to obtain fman€ in& consult with lender or an attorney before corrtrraencin warts or recording Notice of Commencement. A .g STATE OF Rev.812117 PLANfit S S�tiaturnnl'Osrarierdlessee/Cnnts�a��ritsr ttm+s narrrea`Ctstm'aciorJiicensebolder STATE OF FLORIDA COtiNiy�€ Thefor�ing instnmxerttwas edged before me The fongatng instrument was acknowledged before me this ]�day of 2(f2U h'f this�dayof &2112o by F gnV (cam se�.el. F � � trame€u`person Name of persoyfraking sfat eat PL'ISflrralty Known OR Produced iderrtaficatnon Ply l(rt©wn fiR PnUdttCEd ld2ntrllEdtlOrt Type of Identification Type of identification ' Produced �,�,' n Psodut� {Signatureuft s { ofltiot;�yy � Sta�oiFiothlal ,.,Dorf ""••, CHRISTINE JOVCE CONWELL -g• �' - '".Y°"`••_ Commissrott i5to. Notary ►uYBc• Florida Cumrutssi CHRI3TINE JOYCE CONW .� missim9�470i }.. .s u c •State of Florida My Comm. Expires Aug 2r, 2024 ` Commission p G09g470t y Assn. gamed through National Notaral `••`..., rv�My Comm. Expires Aug 21, 2024 ' Notary Assn.. REVIEWS +'Fi�fJrdT ZUNIidG SUtsEi€LrgStiii