HomeMy WebLinkAboutBuilding Permit Application Jul. 6. 2015 7:42AM No. 1897 P. 2
„L1.APPLICA LEI IP0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number. )567-00
7 Com•
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FC 34981
Phone:(772)462-1553 Fax:(772)462-1S79 Commercial Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LaCATI:ON:..:,.. .:: :'
Address: oely XE.
Legal Description:
PropertyTax ID#: 3 Lot No.—
Site
o. _Site Plan Name: Block No.
Project Name:
Setbacks Front Back:_Right Side:.Left Side:
DETAILED DESCRIPTIJQN.'0�--W0RK: <... . :
R:IVI TIOIW ::
CONS'C'R�UCTIOWINFO. A
7HVA
a wor to e e orme under t is permit—c ec a appy:
C �Gas Tank E]Gas Piping _Shutters L,Wind ws/Doors
11 Electric F-1 Plumbing []Sprinklers Generator El Roof
Total Sq.Ft of Construction:: S .Ft.of First Floor:
n truction: 3doo°� Utilities:'t Sewer 11 Septic BuildingHeight:
Cost of Cos $
Q1NN ER%trESS'EE: :
.UlTliiCTO R;
Name Name: `'
Address:5 j 1/ � Company:
City:15t.4)I ffe _State:EL— Address:
Zip Code �. Fax' City: State:
Phone No. �����-� ".�� Zip Code:3 Fax_
E-Mail: Phone No.
Fill In fee simple Title Holder on next page(if different E-Mail: n1 ro IP, 0 fa LOre,
from the Owner listed above) State or County License-e
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
■ Jul, 6.V.20L151, 148PN�M No, 191550 P. 1/li
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DE5IGNER/ENGINl:t7t: _IvotApplica a MOKMGECOMPANY: NptApplicable
Name: M Name:
Address: Address;
City: State: CRY: state
Zip:_Phone,, zip: Phone;
FEE SIMPLE TITLEHOLDER., —NOt applicable BONDING COMPANY; 1 Not Applicable
Name: Name:
Address: Address
City; may:
dip: Phone; Zip: Phone:
I cartify that no work ar insmliatlon has commenced prior to the i:wapce of a permit i
$t.Luclo County makes no representation that is Storming a p�rmit will authorize Che ermit holder to buil the subject structure
which Is In ca 1[t with any applicable Nonce ownersAssocrat on rules,bylaws or,ark covenamx;h t coax Ict or prohlbir such
=Ncture.PleateConsul:wahyour Home;Owners AssoiJa;ion and review your deed or anyresirtctionsw mayap➢IY•
In comldemtion of the gramfng of This requi ted permit,I do hereby agree that 1 w?ff.in all respects,pe �the work
in accordance with the approved Flans,the Florida Building Coda=s and St.Mie COWW Arnendmeffb, I
The following building permit applications are exempt from wndergoing a full cont u"ricy review:room a IMans,
oaessory structures,swimming pools,fauces,walls,signs,ween rooms and accessary uses to another no 1-residential use
WARNING TO OWNER.:Your failure W Record a Nobae of Commencement may result In your ying tWiee for
improvements to your prQPWV,A NaTJce of Commencement must be recorded and post d on the jobsite
before spection.if you' to obtain financing,consult with lender oar an art rney before
corn cin wa k or record' otice of Comm enoment
s
_Signature of Owner/LessWAgen; nature of Contractor ase Moidar I
STATE OF FLORIDA STATE OF FI,O AA i
COUNTY Of COUNTY 01F'
The forgoing instr meat was acknowledged re me Thee f sting IT15 men wet aduwwled before me
tRit�Qdayof 2D� I 2 U F�by
(Name of parson ackncwledgln (Name of person acknawledging)110 .6'0 ,
1'
Lgofiovc
(signature of Notary Publi -State of P da) (5�goature of Notary oubflc tate o Ida)
Personallyxnown -OR prodl.•ted iderrtff!Wlon Personally Known OR Produced Identification
'type of identification Produc Type arf Ideniftnton Produced
commission No. I) NOTARY PU r,mission No. (Seal)
STATE OF FL R NKZM
Comm#EE211 4 AMM—Nd
S SUM OF ft WA
Rinsed 07/15/2014 . 4benert EM 24
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