HomeMy WebLinkAboutOTTENBERG PERM APPAll APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: .- J— ;1_4 Permit Number:
I<rll 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 TYPE: PI/ , CAMn${ ou¢ ,
Address: M/
1'Ver l\Vi v
Property Tax ID #: 3s l 9 - D I -• o(XD 2 -(D Lot No.
Site Plan Name: RinrL, ni.
Additional work to be performed under this permit— check all that apply:
on!
�/iviechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: Cost of Construction: $ Ksp IY
_ Generator _ Roof _ Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Name t1 Name: -34t,hTo&0
Address: $SIB S =hcilath �RW¢ - 1r. Company: eV Ct C fA-
City: F{ T---ivrcQ State:JZL Address: �Z_ / (J . i yh /na,Iou.2
Zi 4`�- Fax•a rk
Zip Code: 5 : City: & ^
M Irt�tt State:
Phone No. L194 90041- Dy S'J(, Zip Code: 3g9%0 Fax: R7Z-219-37_42
Phone No 77Z— Z I I — 3
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County Lice
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
UttiUNIl:Kr t J'4U vt tK _ Not /Applicable MORTG4C-E�MPANY _ Not Applicable
Name: Name:
Address: Address
Oty: Sate: Oty: Sate:
Ztp: Phone: Zlp: Phone:
FEES M RETTLE HOLDER
Name:
Address:
Oty:
Not Applicable
BONDING
Name: _
Address
Zlp: Phone: Zp:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
Not Applicable
u. juae wuntymaicesno representation tnat isppranting apermit will autnonze the permit Molder to build the sib act structure
which isin conflict with any applicable Home Ow�erSAs§DClatlon rules, bylaws or and oovenantsthat may restrict dr prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
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 a. Lude County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNINGTO OWNER Your failure to P, cord a Notice of Commencement may result in your paying twice for
improvementsto your property. A Notice of O)mmencement must be recorded and posted on thelobsite
before the first inspection. If. you Intend to obtain financing, consult with lender or an attorney before
STATEOFFLORDAc I SFATEOF FLOPoDq��
COUNTYO �� �. OOUNTYOF /�/r�
The fo_rgpinginstru entwag`dcnowl og byre me
this day of GI'C
Commission No.
BRYAN
,��o"FIRES: October 19, 2922
Revised 07/15/2014"'.WNW BOedeethmNot7mn„�,•,.,,-._
The forgoinginstru entwasacknowledgedbeforeme
this day of J'(200 by
person
Known V ORProduced
Type of
O)mmisdon
MY COMMISSION # GO 241369
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