HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED, i2
Date: Permit Number: I "70J'0019
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ✓
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATIO.N: ,
Address: Q���" CPIa✓7 �/ c30L1 .
Legal Description: 69 VJV)ds ('.t indoYninUrn
Property Tax ID#: -g5OZ— QJOq-- OO z0-• coo- -] Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side-i
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DETAILED DESCRIPTION OF-WORK:
5acf Ac Cho c e ocxi �fiOn � 1 to cS��� � r7
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C_QNSTRUCTION INFORMATION. 1
Add
itiona workto a er orme un ert is permit-c ec a appy:
❑✓—HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers Ei Generator El Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor.
Cost of Construction:$ Ivy Utilities:0 Sewer D Septic Building Height:
-OWNER/LESSEE: ;CONTRACTOR.';`' �
Name LI (20VO� g� 30 Name: I _ � nuo
Address: IC0=14 r 'fin �� Company:se(?i'V ice �le.yica
City: ensen ►�jeoch State: Address:als5 kW k3rn 'Cf
Zip Code: 1 Fax: City ��( f�GfeYG�c�IQ. State:�j
Phone No.��a-c -`z� Zip Code:33- C Fax:6?64q-q7 /
E-Mail: Phone No.q69�1-q7lq7 11CD
Fill in fee simple Title Holder on next page(if different E-Mail: /fiS i?)L¢ c JCeQh'!eY/CGS •GL'✓r7
from the Owner listed above) State or County Lic nse: . V I -Pq
If value of construction is$2500 or more,a RECORDED Notice of Commencement is rei quired.
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SUPPL.EMENTALCONSTRUCTION LIEN LAW INFORMATION:", `
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 the permit 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 fu I concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms an accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commen ment may result in your paying twice for
improve nts to your property. A Notice of Commencement mus be recorded and posted on the jobsite
before th ' t inspection. If you intend to obtain financing, consul with lender or an attorney before
comment n ork or recording our Notice of Commencement.
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Signature:of:Own see/Contractor_'as=Agent_for='Owners ESignature-of-'contra` "r/Liceris"`H'olde�
STATE OF FLO A / STATE OF FLOR A
COUNTY OF ��l'111 )ot GJ' COUNTY OF ocooyd
The for oing ins e t was acknowledged before me The forgoing inst eat was acknowledged before me
this 7� day of e ✓uart� 20 `7 by this ZS day of �bri rrr'rc J,20 1-7 by
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Vi SO/I i C V� I W160
(Na a of per h ackno (N a of rsoin ackn in
PaY Pia Sheneka Hardy o�PR °�e' Sheneka Hardy
i� � NotaryPublic-
StateofFlorida
commission#GG 33870
2 �, Notary Public-State of Florida
(Sign !. �FeoPrr Florid�'cQ�res (Sig'at 2 of No IPu i r oFF� lorid#_)pires 9/27!2020
Pers • OR Produced Identification Personally nown X—OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION; SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW.
DATE
COMPLETE
INITIALS
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