HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Code ion Dices /
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
PROPOSED IMPROVEMENT LOCATION:
Address: VW7�
QR port( IJY , row iY -11t, 34gA5
Legal Description:
Pad's M k ii"
PropertyTax ID #: 9J Qi) 5 Lot No_
Block No.
Site Plan Name:
Project Name:
Back: Right Side: Left Side:
Setbacks Front
DETAILED DESCRIPTION OF WORK:;
ilio K htat,
a
CONSTRUCTION INFORMATION: aPPY
iti a wor to e e orme un er t is permd— c ec
❑Gas Piping Shutters Q Windows/Doors
HVAC —Gas Tank
❑Sprinklers Generator 01 Roof
Electric ❑ Plumbing
S . Ft. of First Floor:
Total Sq. Ft of Construction:
O Utilities:Sewer 11 Septic Building Height:
nWNER/LESSEE
City: r
Zip Code:
Phone No
V
if different
Fill in fee simple Title Holder on next page l
from the owner listed above)
Or moreE
, a RCORDED Notice of Commencement is required.
TOR: — — --
Name:1`!I
Company:
Address:1-11, ^^^ — State:
City: fbi
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€n consideration of the grantirg ofthi4 tevitieSted perr d, € do hereixy aKreefhat I Pain, in all respects, perform the work
in accordance earth tile approved {mans the Florida Building Codes and SL iucue County Amendruents.
The following building permit applications are exempt frorn umle€going a fun amar € aney revieuv: room additions
accessory struc€sres martmorM pools, fences, vans, sgns screen roams and accessory use_ to anoEheF non-residerral use
WARN116S TO OV4KM -four Wdure to Record a Kotke of Coirmniarweimenit nWV result inyottr Mft ;gree for
Srnprovemer €ts to your property. A Notice Of Ccsrt Mencement Must recorded and posted on lire jobsite
tretore the first Snspection- if you intend to obtain financtn& Consult wvth Sender or an attorney Stere
STATE OF FLORIDA
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Theinrgowg instrument vrasadtnowledgedhe%reate
thls2 ay of�jf� 2ELV by
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Personany Known OR prod €dertfi6tation
Type of identification
(signature of
The forgoing kistroment was admowledged before me
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F1 Notary Public • State of Florida
Corarrissionrd4- Commission i16U 701 Commission
`.,•.,,,,,,,,,: tPnm. Expires Aug 21, 2024
Bonded through National Notarl-Aw.
REVIR TS €Si Y , s ZCtSM.6 ]} 5#3pEtiirMIl a LAiiiS
I COURtTER REVIEW [ REVIEW REVIEW
Rev -812117
JOYCE CONWELL
c - State of Florida