HomeMy WebLinkAboutBuilding PermitALL APPLIC(A1 E INF PIMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 11%1�V 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 �II
PROPOSED IMPROVEMENT LOCATION:
Address: I qL
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
ESCRIPTION OF WORK:
LtkQ r t�Ce' SVtstu(l 1 46Y), (u- sFEp L n(le) - AC�
CONSTRUCTION INFORMATION:
Additij(hal work to be ertormecl unclertnispermit-c ec all that appy:
HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
OElectric 0 Plumbing Sprinklers 11 Generator F Roof
Total Sq. Ft of Construction: / MM
Cost of Construction: $ lQ � V .
S Ft. of First Floor: _
Utilities:n Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR: '
Name Q. E r USSO
Name:
JGl.
Address: O(�
Company: BoylQ, Nr
WYAf jdik14/A[� 0451X_
1m�
City: FO( Y(tree Stat :_
Zip Code: G30PS1 Fax:
Phone No. i I, - Jo2�? (J
Address:50A ( SPP Yi �Y .
City: fbr& I trCei
Zip Code: '3 0 S )
Phone No. Pl( -- Fist(
State: k
Fax:
-414 -
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:a
1;p0. an n
State or County Licen e:
CA -0,111-9 V
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAWINFORMATION:
10.1
DESIGlyEg/ - _ Not Applicable
Name,
MORTGME AW. _Atom Applicable
Name:
Address:
Address:
State.• _
Zip-- Phone
city- State:
Zip: Phone:
FEE SIMPLE TITLE HOLi)EF. y Not Applicable
Name:
SONDMIS COMPPANY. -"Applicable
Name -
Address.
Address:
City:
Zip:Phone:
City-
ityZip:
hone:
Zip: Phone-
_r. _ •r _ a re a' r1i71Raa a > -<
In consideration of the gran€ing Of this requested permit, t do hereby agree that I wiH, in all respects, perform the work
m accordance r,fifhthe approved plans, the Ronda Bolding Codes and SL iude County Amendments.
The following building permit applications are exempt from undergoing a full corcurrenCy review: Mori additions -
accessory structures, swimming pools, fences, walls, sighs, scream rooms and accessory uses to another non residential use
WAPJQNIS TO OWNEilk Your i'adure to Record a Notice a Commenceraerat may result in yA payiIng taiefce for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. tf you intend to obtain finantin& consult mrith lender or an attorney before
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STATE €3F FLORIDA
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REVIEWS FROM . 2014ING, SUPERV5€ R
Pi.AKS vEOETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COIl9PLETE4
Rev. 812127
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