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HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C( �� I %� Permit Number:
' VtO boo l
Building Permit Application
Planning and Development Services
Building and code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-M3 Fax: (772) 462-I578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 139 q 1 024
r
Legal Description: Sy1I gb
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
L`► [c2 (i�� Li lC� '. wt s�zi f ( 3 f�� R ua i D 14 'Sew,
10, Pacica§t unit- wi-wL
CONSTRUCTION INFORMATION:
iti na wor to e 132ilcinieclun ert ispermit-checka appy:
Shutters Windows/Doors
HVAC Gas Tank❑{Gas Piping _
_
rQr
Electric EiPlumbing L_.ISprinklers ElGenerator IJ Roof
Total Sq. Ft of Construction: 4 �y� Sqj Ft- of First Floor -
E]
Cost Cost of Construction: $ O U11. Q� Utilities: I Sewer Septic Building Height:
O W N ERAESSEE:
CONTRACTOR:
Name en + :
Name: 1
AddressJ3CIga nal�l
Company:
a
City: #�(f it C E State:'
J'JT,
Address:5(© Pr �t fi l f ky-
City: YU(-b— erc& State:
Zip Code:
3�1LOS1
� r PPFax:
Phone No. I l DL - 46 5' la 0 Z 4
Zip Code: .3 4q 5 E Fax: 7?� 46 -373`7
E-Mail:
Phone No.-M- q0{-41' H
Fill in fee simple Title Holder on next page ( if different
E-Mail: P it (rl
State orCou�nfe: CAAlI$I8t$
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPP€EMMALC€ S"i UMON LIEN LAW IWORMATION:
DESIG MGM_ Nrit Applicable
MORTGAGE AMV: _ Not Appiicable
Name-
Name:
Address
City, Slate: _
Address:
City State:
Zip: PPusrae
Zip. Pion:
I=EE SiMPP-EEM € . NotApplicable
BONDING COMP Plat Applicable
Name:
Fume:
Address:
Address:
rag: frhone:
Zip: Phtxte
OWNER/ OR AFPD `: Applimtion is hereby madeto obtain a permit to do the work and Installation as indicated
i certify tthat no work or instaftaaion has mmmenced priosto the issuance of a perrnii
Si iancis C 3.m f makes rm rep esentation that �is- Mgr�anting a perallwilf authorize the pesmi£ i;ofatex to build subject stnxtuse
vahrch ii in with any apphsabfe loom_ Ow:tErS Assacratttua EaafLS, f}y3dw5 orartrt cov2nanfs that iri3'yt 7e5trlCt ar prohibit SnElt
-mayapply-
structure_ Please consultmkhyourHomeownersAisoctauorandreviewyourdeedforanyrntrictionsw.
in consideration, of the granting of this requested permit, 1 do hereby agree that d win, in all respects, perform the work
in accordance with the appraved Plans, life Florida aulding Cordes and St Lucie County Miendanens-
The following bi ding permit agfi3ications ace exempt from undergoing a full concurrency reiriemr. room additions,
and accessary use to another non-residenbat use
accessory structures, swimming puotS MMS, waifs Signs. screen rooms
WARNING TO OWNER- Your taatife to Record a Notice of conanumcement may reslidt in your paying'mire for
A Notice of Contnfencen-ent must be recorded and meted on the job':fte
improver Bents to your propei4,_
before the first inspection. PE you intend to obtain financing consult with ;ender or an attorney before
<-nmrr+erar-trio smra r nr rscmdine vour Notice ofCommencement_
The forgoing instrMentvas admowledged before me
this nN^ day of g/� 20 74 by
MichaeA F Sov lei
KamSutbuES
PessonayKnown�CR Produced fientificI8or
Type of identification
Camraiss-M N , 1" ' .. CHAISTINE JOyC[SQtl1}ELL
Notary ublic - Stan of Florida
t7 Commission Y GG 9847ot
iA _�` u„c„mm. EzoiresAW Ii, 20U
t to �{fiT ia+ f}
Rev.
ThLL fbTgWng instrument was adonowledged before me
thisl4t- day of - Z.
1 2010
*a
Name of pempinaldrig statknent
pem< OR Produced kienUfficadort
Type of +e + ra +
Produced,
rj
Notary Public - State
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