HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12-11 L-1 16 Permit Number:
I Build! . ng Permit Application SCANNED
Planning and Development Services BY
Building and CodeRegulation Division it. Lurie CoupW
ijbo VirglnWAvenue, Fort Pierce FL 34992
Phone: (77.2) 462-1,553 Fax:�(772) 462-1578 Commercial Residential
III PERMIT APPLICATION FOR: To Select from dropbox, click,arrow-At th& end of line III
Address: k—D
Legal Description:
Property Tax fl) #-,
Site Plan Name:
Project Name*
- \—Jt '\ -
Setbacks Front Back: _Right Side: Left Side:
/1 [1 *V� 6() f+ Ir4- b Ckuo- wc(y\&�
2-71-111+�OV t.t I A, � JrA�
EIHVAC UGasTank []Gas Piping U �"hu t . ters
2 Electric El Plumbing E]SpCinklers 0 Generator
Total Sq. Ft of Construction: S Ft of First Floor:
Cost of Construction: S3L93 Utilftle's"n Sewer E]Septic
Ct ff7,LJ,
Lot No.
Block No.
PCLM' I +G 42cx a
-Windows/Doors
Roof = Ro4pitch
Building Height:
Nanne'I)R
Name: nOIA& "�Ied-t—
Address: Nlbc, UJ\Kk�r�- RA 0 E
yl C C-
city: Y'0 C� i�� stat
Zip Code: -YIc\ Fax: '3 CL W1 -q �Zq
Phone Nd.
city: State..
Zip Code: 31�ZL, Fax: -ni 5)") 2
PhoneNo.
E-Mall:S1
�Cdretfi Q AV hor-fori. cti(Y-N
Fill in fee simple ratle Holder on next page ( If different
from the Owner listed above)
I - . I
E-Mail:
StateorCourityLicerfse: mz'�2'01k-j!�;gs
I . - - ;5 C5�k 7,5 ,
If value of construction Is 0500 or -more, a PECORDED Notice of Commencement is required. '��3
�SUPPLE S, M
1�,�KWITM
7�7 , I �i
Name:
iYOt Applicable
P.A. ORTGAGE'COMPANY.
Not Applicable
Name:
Address:
Address:
�L
C
cll�f_
State -
State:
Zip: Phone:
Zip-* Phone-.
'FEt Sj� ILE TITLE HOLDER6
Not Applicable
tIONDING.COMPANY-.
NotApplicable-
Name:
Name:
Address:
Address:
.Aty:
C11 ty: L .
,Zip; PEone:
-zix—Phoo:
.1 certify that no work or installation has commen Pric to the iisuance of a permit.
ced e
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In consideration of the granting of this re�uested penrilt I do herebyagree that I will,lin'611 respeqs, perform the work
in ictordancewith the approved Plans, the Florida Building Codes and'SteLucie county Amendments.
Thefollowing building permit aP"Plications are exempt from undiergqInga iuil cancurreneV review: mom additibnS4
accessary strUctu'ms, SWIMining pools, fences, walls, signs, si;reen too
ms and accessory uses anothernon-r_e'�sldentlal use
to
WARNING TO OWNER: Your failure to Record a Notice Of Commencement may result in Y . Our payin 1 9 twice for
[IMprovemerIts to your property. A Notice of Cornmieric'ernent Must bie-recorded and posted oh the jobSite
before the first inspection. If you intend to obtain financin& coris;ult'with Iendbr or an attorney before
comrmenciiiL� v�nrk nr.ro,r,4' �� Ri.i_ -s
The foqoing instrument was j
this Ptknowledged before me
— day of - DA iicoA 6AV'� 20 1LO-by
Ing Instrument wzis acknowledged before me
day of be_,Cz.�V4� 20 _Lkp by
Qda)-, &S6 A slc,�-k
(Name of pi�rsoriacknowledgingj
�&Florlda)- _(Sigridl of Notary Public,SWe of Florida')
Personally Known OR Produced Identification
Type'orldentiTication Produced
Commission No. -IS4
PCv!SedJQ1I15j2014
'REVIEWS—
—FRONT--
204ING,
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE I
MANGROVE
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COUNTER
REVIEW,
REVIEW
REVIEW
RE, V1 V
REVIEW
REVIEW
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