HomeMy WebLinkAboutPiles Only RequestI
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL
34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit No. /&02 -ar�s �F
I ROBE;L-r -57AIVAnO41 understand that I am proceeding with
the pine at my own risk. I understand that there is no
assurance that my permit for the entire structure will be granted and
that I accept full responsibility for any changes that are required in the
foundation/piles design including but not limited to location or design.
Contractor
STATE OF FLORIDA
COUNTY OF i
The forgoing instrument was acknowledged before me
This '�— day of %7% I .20A by
of person acknowl dging
(Na7Z
(Signature of Not
ry Public- State of Flori )
Personally Known OR P?eal)
d IdentificationType of Identification ProducedCommission No.
,o.Y °��•., AUDREY B. HUMPHREY
`= MY COMMISSION # FF 174772
EXPIRES: March 6, 2019
'c),,6 Qr` Bonded Thru Notary Public Underwriters
RECJEIVED
MAR - 3 2016
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL
34982
Phone: (772) 462-1553 Fax: (772) 462-1578
/P 7e-sMenly =aMel
16 03- 0-0 CQ v
Permit No. 14w- - oay 4T-E�
understand that I am proceeding with
the pile no
assurance that my per and
that I accept full respoi �i the
foundation/piles design gn.
r �) 4n
Contractor 1-2 -� e
STATE OF FLORIDA
COUNTY OF Aasackn'�
-- - - -- I2
The forgoing instruments
This -8— day of
(Nam of person acknowle in )
JA
(Signature of Nota ry F
ublic- State
Personally Known OR Prr -" � m-
I J
Type of Identification Produced �------�-�----�-�----�--�----�-�-,---- � : - - -----
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Commission No. ;9 I
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