HomeMy WebLinkAboutBuilding Permit Application Feb- 17, 2017 12:43PM Barker Air Conditioii 7725625340 No. 8757 P. 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: r Permit Number:
Local_ RECEI ti's D
Building Permit Application F
EB 17 2017
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-157$ Commercial Residential _ X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address:;'3q ?(-) 1�, " I
Legal Description: la Ucf
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Property Tax ID#• 14 - P,- c-, Lot No.
Site Plan Name: i C1 '1�:)6Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
t ti l6,:DESC-IM-P.T10;N 0`F FORK: 77
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CONST I.COd,KFOR°MATIt�N::
Additional WorKto be pertormecl under tispermit-c ec a appy:
9VAC Gas Tank ❑Gas PipingShutters Q Windows/Doors
Electric Plumbing ❑Sprinklers E_Generator Roof Roof pitch
Total Sq. Ft of Construction_ S .Ft.of First Floor:
Cost"of Construction:$ Utilities: Sewer 0 Septic Building Height:
Q1d N-ER/iJESSEE: C DN
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Name t CI- y Name: MOZ.r( ltc, �_� t t✓ ::s
Address�gzC~' Company: Eawu - } IL
Cityl�)j'+ I?1 State:' Address:iq-?�i 0
Zip Code:•. Fax: city:yey'l`) koe-i rn Stater
Phone No. Zip Code: , �DQ(()(;
E-Mail: Phone No:71-1
Fill in fee simple Title Holder on next page(if different E-Mail: "
from the Owner listed above) State or County License: VA ._7 -1
If value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
Feb, 17, 2017 12:43PM Barker Air Condition 7725625340 No, 8757 P. 2
SU PLE-MENT- AL CONSTRUCS..4 14',LIE:N.,I 'W,',j;N',FORMAT.—IO.N:
DESIGNER/ENGINEER: ,Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address; Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or 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 St. Lucie 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
WARNING TO OWNER:Y ur failure to Record a Notice of Commencement may result in your paying twice for
improvements to your p erty. A Notice of Commencement must be recorded and poste on the jobsite
before the first inspecti n. f you intend to obtain financing, consult with lend or an att ey before
commencingrk or r or 'n our Notice of Commencement.
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Si ature of Owner/Lessee/Contra oras Agent for Owner Signature o ntractor/License Ho
STATE OF FLORIDA-- STATE OF FLORIDA--m
COUNTY OF _!_nc�lCln Ir COUNTY OF 0.Y1 R1UP
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this l7 day of 20 L—Lby this I lt'�day of n 20 j by
MQI?�l A . HATA0rET1S MA99-A• H aULI. AC1`1S
(Name of person acknowledging) (Name of person acknowledging)
n
(Signature of Notary Public-State of glorida) (Signature of Notary Public-State of Florida)
Personally Known�,/ OR Produced Identification Personally Known��OR Produced Identlfltation
Type of Identification Produced Type of Identification Produced
Commission No.FF r' �•,,,,,,, ea ission No,F�-" 0A ANN MURRAY
EARBARA ANN MURA Y `�' Notary Public-State of Florida
Notary Public-Slate of orida •
••_
W+y• ,�_My Comm.Expires Aup 1 B,2019 9,;,.�, r� My Comm_E>tplrGeffifflissfon#FF 23
es Aug 1 A,2019
Revised 07/15/2014 BaadedtlYt RKlo�t�wryAm, `; .," BoldedthroupllN�tlonflNataryAsSn.
REVIEWS FRONT ZONING SUPERV15OR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALST__ _ 7_ 1