HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: .! Permit Number: 1r L1
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Building Permit Application MAR o 7 2017
Planning and Development Services PERfAiITTWi -
Building and Code Regulation Division St. Lucie C>,;
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ./
PERMIT APPLICATION FOR: Mechanical
Address:_ cSQI ;;f Vt?Y��1 �� ,�!?
Legal Description: pJne6 G -the
�e 1he5e),ye (f g
Property Tax ID#: __"13ZZ-6OZ" 00/1-7 -0000 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
F.xod CIC cc11 5 tori •-- 1 s':Se e r -r /1) J_'ul//
itionWwr toe e Orme un er t is permit-check a appy:
HVAC Gas Tank FGas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ IUy� Utilities: Sewer Septic Building Height:
Name-In a -)C,� uIy i1
k Cciunir)e _ Name: cr O LeyiosOn
Address::�3t_6 fC WrC. r Company: k�cfyice America
City:. Y,tb G State: Address: 015U Md (a5'"cl a
Zip Code: 10A I Fax: City:T-� l.£1udeOct ie State:
Phone No.qj9_913-Oq 10 Zip Code: Fax: gIC-"(317_1-3G9I
E-Mail: Phone No. I00
Fill in fee simple Title Holder on next page(if different E-Mail:Tll� qrc T '�fV jC'�c /?IeIiCG?t0�'I j
from the Owner listed above) State or County License: CACQl Jt0(q
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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 undergoin full concu ency review:room additions,
a sory structures,swimming pools,fences,walls,signs,screen roo s d access uses to another non-residential use
MNN OWNER:Your failure to Record a Notice of Co m n ent ay result in your paying twice for
to your property. A Notice of Commencem t st e r orded and posted on the jobsite
tinspection- Ifyou intend to obtain financin c suit ith lender or an attorney before
ork or recordin our Notice of Commence e W.
N�u
s
Sig ture of Owner/Lessee/Contractor as Agent for Owner Sign re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA &ivayd
COUNTY OF roward COUNTY OF
The forgaiing instnt�w acknowledged before me The forgoing instr m nt wa acknowledged before me
this day of �r(a ' 20 n by this�7�1 day of Qr 20 0 by
(A i av sore 4a 0601' 4a17
(Name person ackn wledging) (Name f p on ackn d in
Shenea Hardy "'RY POs
Sheneka Hardy
Notary Public-State of Florida
° NotarYPublic-State ofFlorid
a
(Sraf ary P Flor' res 9/2712020 (Sig o f lora �ss�on#GG33870
xpires 9/27/2o20Peownro uced Identification Personal y own OR Produce en i
Tyific ' nProduced_ e o tifica ' n Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS