HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 101 S IZ6 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division /
2306 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: QQ toi (.mtpl x fk 1 lercz _;3I.PNS
Legal Description: ISUillen Por l'+1 P
Property Tax ID #:
Site Plan Name:
Project Name: _
Setbacks Front
Back: Right Side: Left Side:
,DETAILED DESCRIPTION OF WORK:
t>1,Yi i� W I-I'h I o Kut h?cc�.
CONSTRUCTION INFORMATION:
�FirGt� o ��mr to o nc nrmc un ort �c normrt— rT.n G STI t �t o.... ..
L—VJHVAC L.. I Gas Tank L_JGa!
11Electric ® Plumbing ospr
Total Sq. Ft of Construction:
Cost of Construction: $ L4.1600. 00
Piping L_1 Shutters
ars l J Generator
So F�t.� of First Floor: _
Utilities: Sewer 11 Septic
Lot No.
Block No.
Windows/Doors
ORoof
Building Height:
OWNER/LESSEE:
CONTRACTOR: ,
Name `2PdSvlIrl 0611L IfOfm soeS�'(r C •
Address. _ P1 I,V_'3lsj' A/Q,
Name:
UU
Company: / T lf/t l (r_
City: "o 8ach Stater-
Zip Code: t4giq Fa :
Phone No. 15 ( I f I QS
Address:510 A_EtMOILL Firrl,
City: ( rte(CQi State:
Zip Code: 34q,51 Fax: Z7.1' 4& -3%3`i
Phone No._""a _ Atp[-41 0
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: ` Il Ibonn 0-f) (MI
State or Coufte: ipcC.lg IS[$ (D
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPI�LEi�EATfAi_ i7Cf'!flN ltEl�# i.AA1tl� tNI2BalIAT[t)�9.
DESICtaaa.+y Ei�C7IlUE€R�
Name:
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dame:
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City:
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State:
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OYMER% CFM AFF DVff: Appbcaum is hereby ntadetotnbtam a petmitto dothe work and in�fledm as indicated_
1 certify thatno work or installation has commatced prior to the issuance of a permit
Si Lucie Ca makesnorepresenm-DnihatisgranringagernitwdiauthoreeUaepermltholderto thesubject structure
which ism conflict with any applicable Home owners Assoaation rules, bylaws orand covenants that may restrict or prohibit such
structure- Please consult with vow lime Owners Association and review your deed iirr any restrictions which may apply.
in consideration of rate granting of this requested permit,1 do hereby agree that! wilt, in all respects, perform the work
in accordance with Lite approsRd pians the Rorida 6uelding Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swi lffIRM Pont, renes, wails signs, sa-eim rooms and accessory uses to another non-residential use
WARNING TO Your failure to Record a Notice of Commencement array re=sult in your paying twice for 6
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection- If Wu intend to obtain financing, consult with lender or an attorney before
commencira work or recording Notice ofCommencement-
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Rev-812137
Stgn-attve o€ Corttiactorjiicense Hestder
Signattare downer% irssee%Coniractar -Agent for ones
StA•fE OF F:.tERIDa�, �
STATE OF FI t3RlDA
t:CitiNTY til
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this SI'a` day of. Oc�-dhel .26 Eby
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Name ofperso nakingsraf�ment
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Type o€Iderritfication
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Notary Public •,�4te�gf Florida
Commission No mmisslanl�iA44701
;�pr off•., CNAIS'rINE JOYCE CONWELL
Coinra1i55itNt Notary public, Ste da
•��`�•'�
MY Comm. Expires Aug 2�, 1024
Banded through Natfonai NotaryAssn.
� IssfonkG6 d�
_ '�or I' My Comm. ExpSras Aug 21, 1024
' Bonded through National Notary Assn ,
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