HomeMy WebLinkAboutNaranja Ave 164, Permit AppAIIAPPLICABTE INTO MUST BE COMPTETED FOR APPTICATION TO BE ACCEPTED
Date: Permit Number;
s,t; Luclit!
Plonning and Development Services
Building and Cade Regulatian Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: 1772) 462-7553 Fax: {772l' 462-1578
Address 1
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Building Permit Application
Commercial
F lll
Residential
CBDG Funding
Property Tax lD #:
Site Plan Name:
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qK3
Lot
Block No
Project Name:
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PROPOSED I MPROVEMENT LOCATION :
DETAILED DESCR]PTION OF WORK:
I -T-
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION IN FORMATION :
Additional work to be performed under this permit - check all that apply;
*Mechanical * Gas Tank * Gas Piping _ Shutters
_ Electric __ Plurnbing _ Sprinklers _ Generator
*WindowslDoors Pond
{ V-pit n
Totat Sq. Ft of Construction t?cr->Sq. Ft. of First Floor;
Cost of Construction: 5 lt7loo -Utilities: _Sewer _Septic Building Height:
CONTRACTOR:
NA Name:
QWr dAddress:
City Statei[:L--Address
zip code: 5LC S fu-L p2*
Phone No. E-Zip Code
Mai
Fill in fee simple Title Holder on next page (if different
from the Owner listed abovel
State: {.'::-L-'
Fax:
phone ruo "1-I l" .f [l {_('q-( ?- |
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lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required,
lf yalue of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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OWNER/LESSEE:
State or County iicense Ca-. C.Cl j '{ 3Q Q
_ Roof
PERMIT APPLlcArloN FoR: K'f .f Db+
DE$lGI{fUEN$lltl[ER: _ Not,ApBlicable
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lip:
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Slatc:
MORTfiAGf COMFANY: * Not Applicable
F{arne:
Address:
State:
lip:Phorre:
City:
r[f SlklPLE TITLE HOTDER: _ Not Applicablc
Name:
Citv
';,; n .Phone:
Adtlrers:
SSItlnlN€ CSMPAI{Y: _f{ot Applicable
Narne:
Address:
City:
lip: _ Phone:
i r:r'rtiiy tirai no i,rork or rnrtallarion h.,rs conimencerl prii.rr (o tirr il;1u;rlc. of ;r perrnit.
in trCcr:iC:rrce,,',rtir thu tp;.rro,,,i:ci pirn:, thr: ilc,rida BL:iliiirr1,, (rici.t:. ani 5r,.l.irrr,, ClLrnty Arnr;tdrrrcrrt:,.
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W/ OR Froduced ldentification
lypr:ldr:nirf icaiion Frorlucrri
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{or Irlrvliclrl Prc:,c11tr.or. . - . (.i;tlirir.' NoI.iritilirL)n
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Name of person making staterneflt.
o; Noilry Publir- StaI*
{llrn l r-rission
day of
STATE OF FLORI
CCIUruTY CF
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beforc irri: oi
.rt L Li)y
i\,'lANGfl0Vt:
REViEW
i'l f:\i lir Vt I FRONT
COUNTER
ZONIIJG
R[Vli:!V
SUPERVISOR
REVITW
PLAhIS
RIVIEW
VEGETATION
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SU PPLEM ENTAL CONSTR U CTION LI [N LAW I N FORN/1A-I-ION :
WARNING TO OWNe R: Your failure to Record a f{oticc of Commencement may result in
be rc.cordcdy0urACr:mniencerlenl milst
0n the first inspecti*n. lf
or wot k