HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO PdUST BE COMPLETED FOR APPLICATION TO $ E ACCEPTED
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Planning and Oevctopmen t Ser,rr'ces
Po rm it Nunn h er:
Building Permit Application
a1111-dr'Y?:9Cmd Ccde Regilfatbn Dh sror7 Commercial Residential
2300 V r;fniv Avenue, Fort Pierce F134-9.82 --
Phone: (772) 46 -15S3 Fax: (7721) 462-1.578
!''PERMIT APPLI TION F0R,
FR �i l' EE EITT L0CATI0N
+ i U. 4�_
PropertyTax I �—
Lat Na_
Site Flan Name:
Block Na.
Project N a rile: y `
ET ILED DESCRIPTQN OF WORK:
New Electrical meter Second Electrical Deter ;1'S4LJ 770J Lrj�,
CONTRUC T GON INFORMATION: i
Additional work to be -performed under this Permit— check all that apply,
`Mechanical — Uos Tanks _ Gas Piping Shutters
— Eller-tric — Plumbing
Total Sq. Ft of Construction)
Cost of Co nstru ctio n F 1
—Sprinklers
A(ddress: �j
o 1k + V G
City: l • 4. z State:
ZIP Code: 1 7 q Fax :_ 11,P7
Phone No. 1 4F —q
E-fella U : /f/,
Generator
Sty, Ft. of First Floor,
Windows/Doors Pend
Roof Pitch
Utlkiti.ies-_ — Sewer — Septic BuiUng Height;
rill in fee simple Title Holder on next page ( if different
from the Owner 1 isted above)
CONTRACTOR:
Name: I n+ f-tuyg
Company,_ f(u"i,_� tr-V,-)S�(.JU6n
Address: o I I -
City: Stater
Zip Cade: 7- Fax: -7
Phone Na 4Q JIK
E-Ma i I �L't rm '�r�'f &' r'►
Stag or Coklrity Licenser_&C rf 1-16
If va lu a of cou5truction Is 25 U0 or m ore, a RECORDED 110tire of Ca m menCernent Ls req u fired.
If V2lue Of HAVC is 57,SDD or rno re,, a RECORDED Notice of Commencement is required_
F5tJPPL�MFTAL C 0 NTl�IU�TI —
_ � �� �� LA111� I�1 FOR fATl0 N:
Name - JAI- c
Address.
City; State:
Zip; Phone �--
Na e- TITLE HOLDER: _317NOt _AP PIicabJ'e
Address:
City:
Zip: Phene:
MORTGAGE COMPANY: ��J�t icable
Name:
Address:
ci• State
ZI-P: -__ PhQne:
BON DIING CORVAN Y:
Namez Not Applicable
Address,
citv-,
Zip- Rhone,
OWNER/ CONTRA Ff —
Application is hereby made to obtaiin a permit to do the woi* ari�d instal ratiindicated.
i certify that r10 work o r i n sta I I ation has com me aced prior to the issuance of a permit. on as
fit. �e un makes no representation that is granting a permit m4li autharFze th orrnit bolder to build wh i cFr is i n ni l ct with and a ppli a bJ H orr� O ers 1ss c� tyorr ru Ces bylaws ild the subject structure
structure. Please consult with your Borne Ov+mers Association a onand ures, revieour d r a � r ni nts that may. r�#riict or prohibit such
il n co nsi deration Of the gra n kin g of th i s req ue5ted permit J do here by agret tha t I wiJ i, irn all e e l o er which he a� �r -
n accord ante with th a app roved plans, the Flori da Bua I ding Cod -es and St LLrcie �, r~ Arnerrcfrn ens the wart
The foilav�i building �errnit apPlications are exempt from +�nde
� �c es�ary 5tru r-tu res, svvi m M i ng pool sF fences, vvi� I Ps,, signs, screeln room and a cc sso ry se a another non -- currency mvi�=_w; room i esld
WARNIN TO OWNER; Your faMloreto Record a r40t ce Of mrrtencernent rE" a re5�It i res�derrt�al use
�rxreeras trurrprk+. A JJt�efiner7cer�t must be necnrddatbe twice for
Lticie County a rid pested on the jobs ite before the fiirst inspection. If you intend toobtainub�ic record-5fit,
With lender or are attorr�� before corlimencir� ��k �r ree�rdir, our Notice of o firrandlnig, consult
tare of Owner/ Lessee
STATE OF FLORIDA
COUNTY C)F r.
ntractor as Agent for Own er
Swp,rn to (or affirmed) and suluscri4ed before me of
ysic I presence o r � On I i nL- Notariaati or[
tFrid da-r of 202§ by
Name
P,e rso n ma kirng statement -
Person ally K n own 0 R Produced J denTifi-cation
Type of I de ntificati on - —
Produr-ed
L�X� r%A _eAv
V19nature cif Notary public- Mate of Florida �
� 'w P JEN?JA L. FR CO
Commission No,
* IPamrnis5ion # GG 8;
EK*m April 29, 202
T 4 ' DX4@d TMu 0Dte N41Rry S4N
REVI EWS FRONT ZONI NG SUPERVISOR
_ COUNTER REVIEW REVIEW
DATE
RECEIVED
SATE
COMPLETED
Signature of contras
STATE OF FLORIDA
COUNW OF
cen5e Hod cler
Sw T to (or affirmed) and subscribed before me of
physic:af Presence or_. Online Notarization
this . day of , 2_G�q by
A
Na m e of person M a king statement.
Personally Known OR Predumcl identification
TYPe of identification �~
Produced
(Sig Cur-e of Notary PL brit- Mate of PRoda �
4: • ■.. .
Qrnrnissi on No,
4� �
_ �Uf F4 I u
JENNAL PP-X
PLANS VEGETATION I .SEA TURTLE MANGROVE
REVI EW REV[EW REVIEWREVIEW
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