HomeMy WebLinkAboutBuilding permit appALL APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Code
ion Division
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es
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:, 1] 03 J,[`tJA f,%rrl� r((?, . Ft 34551
Legal Description: L[14tv000t —MO- l0- Lo-f- I BL.K ti5
Property Tax ID #: 1301 - �e l ' 00 [ S - 000 - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
L DETAILED DESCRIPTION OF WORK:
Gk2 r�ilce: T41sfatI r)gal 3fo✓t ire sees, Lennox
►- >�c� s`1 ttnj wl fo/ h
CONSTRUCTION INFORMATION:
Additipirial work to e erformed under tis permit -Check all that apply:
_ HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
11 Electric Plumbing Sprinklers Generator 1:1 Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 400,06
S Ft. of First Floor: _
Utilities_Sewer Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Ct
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Name: tat
Address: 40 131y
Company:
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City: cor+, IPj ffC2 State: Cfi
Zip Code: 3051 Fax:
Phone No.7?Q1, -AM- �!Z 0
Address:5(o I &P.Pdp M_
City: fb(-b Ref
Zip Code: Is"5)
Phone No. -VIA- 01-414'1
State:%L
Fax: -71eZ--4(Pto-373-7
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner Listed above)
E-Mail:
State or County Licen e:
CA 0 i$1 S i $ (Q
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPOI _E ENTAI €R€ CMN LIEN 1AW INFORMATION:
DESKNERIENSINM:
Name:
-Not Applicable
l ORTIGsAGE A _
Name:
_NotApplicabte
Address:
Address:
city
Zip: Phone
State-
City:
Zip: Phone:
state -
FEE SIMPLE WILE
Name:
1 Not Applicable
BONDWG COMPAW
Name.,
mot Applicable
Address:
Address:
City:
City:
Ziip: Phone:
Zip: Phone
a - -
In consideration of the grouting of this requested penati9 l do hereby agree that I wl%, in all respects, perform the work
in accordance with the approved plans, the Ronda Ihuldmg Codes and St Lucie County Amendment&
The following building permit applications are exempt from undergoing a full cona:nrrero-Y rev~- room addatioris_
accesory structures, swimming pools, fences, wAs, sins screen roams and accessory uses to another iron- residential use
WARMNB TO GVH4M Your faffure to Record a Notits of Commencement may resadt in your paying twwe for
improvements to your property. A Notice of commencement must be recorded and posted on the iobsite
before the first inspection. if you intend to obtain finandng, consult with sender at an attorney before
rnmmunrins xvnrlr nr reaiwd➢nor vnur Nntice of Commencement -
Signature ArowrlK iQntiatLLmr
!!�mt for - er
Signature Cif Coiatrtactor/ricense Haider
STATE Of ILSTATE
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OF IFLORIDA
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COUNTY€F
Theforgoinginstrumenttvasadmo ledgedbeforeme
iiaefor oit�' mentwasackaaowledgedbefore me
this t-1� day of � 20 20 by
this 11�i• day of UST 20 ao by
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Mich F 1e,
Name
Name of - sta ent
Perswu* Knoll Produ�al iwtiori
Personally Known t3R Produced Iderstification
Type of Identification
Type of Identification
Produced
Produced
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(Signature Of Notary Pi State Of Ronda)
(Sigraataire of htataty Pub' to of Rorida I
Commission No. .......�. .�, i
—XISTiNEJ Li''ONWELL
Commission o,,.°�.......... dRIc7In.. .- CON }
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gs• p Notary Public •State o6Plorida
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# GG 984701
Commission N GG 984701
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev_ 812f17