HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: o Permit Number:
® Building Permit Application
Planning and Development Services
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: i��i
l
t'V1 ds
SAq L%s
Legal Description: Liam
Yl%b1 d S M Ohl 1L Nf1rnOr ?041
Property Tax ID #: 3o 5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCR/I„PTION'OF WORK:
:s LAUD
LI �CQ, •rU( L� ��Q, : T,0{5�� � • U�VI� �(,t1� I i� d
klC VCl) �'1 Ply/•
�
CONSTRUCTION INFORMATION:
itl a Wor to e a orme un ert is permit-c ec a app y:
HVAC Gas Tank ❑Gas Piping Shutters ❑'j Windows/Doors
Electric ElPlumbing ❑SprinklersGenerator I I Roof
Total Sq. Ft of Construction: /� �/� S�Ftj. of First Floor:
Cost of Construction: $ M � b0 Utilities: Sewer Septic Building Height:
OWNERf LESSEE,;
CONTRACTOR:
Name�4V51/l S
Name:
����y��,
Company:S1Ylddln(i -FLC.
Address: QD J� Sf` %Q�
City; CJ State: _9/
Zip Code: Fax:
Phone No. 1 : k. N dL
Address. I0A Ttfi1O Ut �t, FYL J
City: fba'—' R1'rc,& State: f5f,
Zip Code: ,s"5 1 Fax: -71;-- 41Y/P-.373i
Phone M- 4k[-i-I•1 1
E-Mail: 5l$-0`66 - 3`[1 4
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
1No..
E-Mail: r)DY
State or County Licen e: CiirC 181$1 Z lP
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMEWAL CONSTRUCI ON UEN LAW INFORMATl€ N:
iNEElt: _ Not ApptteableTMMTGAGECO
Name•
ANY: ,Not Applicable
Address:
:
city: State: _
Phone
StateZip:
Phone:FEE
sjaa 1ETWEE y 3NotAppiicabteC
Name:
PANY: Not Applicable
Name:
Addre55
Address:
City.,
city
Zip:Phone:
Zip: Phone:
a i i' 'S r i v rcr s _ ar - r. .
- r.
structum Please consutFmUM your rsmne uwaserb ruacn..auv..aa,...c.,c.. a.,... —.,......r ..J- ________-_' -,.
in consideration of the granting of this requested Permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. itscie County Amendments.
The following building pennit applications are exempt from undergoing a full roncurrency review: room additions,
accessory structures, swimming pools, fences, wails, signs, screen rooms and accessory uses to another non-residenfiai use
WARNING TO OWNER: Ymw iagese to Record a Notice of . may result in your paw twice for
improvements to your property_ A Notice of Commencement must be recorded and posted can the lobsite
before the first inspection. if you intend to Obtain financing, consult vAth lender or an attorney before
.m .c rincxsamrk nr n-Amrrlin2 VoUr NONCE! of CornrnenCemertt_
signature ofOwner/ Li- fContracior Agent "Wrier signature of Contractoriiicense Holder
STATE OF sa#
;. (/
f': •..
The forgoing mstryment -was admawlecigadbefore me
this jl� day of 20 � iby
"ichw F Sallle,
Name of person tement
Personally Known ClR Produced identification
Type of Identification
Produced
Their ping instrument was acknowledged before me
this l day of 14 .2021 by
t�cW Jt & i&
Nameofperso aldrigstatilment
Personally Known OR Produced identifitatian
Type of Identification
Produced
-- 1'i5r""e`,•,,, V CHRISTINE JOYCE CONWELL �,.�++o''..,.
• .`r;`; Notary Pubic-Stettroesida Commission'? o
commission a • ion r GG i6�7dt
MY Canm. Expires Aug 21, 2024 �?or MY
"Bonded through National Notary Assn. Bonded
REVIEWS
1-m6ii:
ZOaN NG, SUPERVISOR PLANS VEGETATION
REVIEW REVIEW, REVIEW REVIEW
Rev.
Ctary Public • state of lorid l
�MExpi R GG 9 1
Comm. Expires Aug N, 2024
through National Notary Assn.
SEATMTI.E i MANGROVE
REVIEW REVIEW