HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED�7
Date: _ ( /Permit Number: 1770Co U 0 '3�
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Building Permit Application
Planning and Development Services JUN /Z 2017
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMOkO.'VEMENT LOCATION
Address: Suhr lse- 8�v�• r i��ce rE�. -�I Qg�
Legal Description:
Property Tax ID#: "I C�Q�j� '(91e/y' 7 Lot No.jZ bK33
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK.;' ;
C kcv3, e_ o (�, � -To v e% C(so-1virev, .� �o h l6 seem I TG 7B262 (f
AE.36_3x�( � 10 k.w keae-r'�
CONSTRUCTION INFORMATION
Additional workto e e orme under this permit-c ec a appy:
HVAC Gas Tank Gas Piping _Shutters n Windows Doors
I�L
FlElectric 0 Plumbing Sprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction:' S Ft.of First Floor:
/
Cost of Construction:$ �-t Edo'C� Utilities:cn Sewer E]Septic Building Height:
OWNERAESSEE CONTRACTOR: _
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Name j��-i Se6h 1,� Name: UPi u�� eJ
Address: dna Sbpr'(te_ Company: - e- ldeCisue�
City: Fig ,P,q'Ce, State:, Address: 0411 S. 8a444 kj,
Zip Code: 3 CM g;L,- ` Fax: City:_1 - p lee/ccel State:.
Phone No. ?��` 2 (p - 2110 Zip Code:' JYCnJ Fax: �d�-Y�j��q�(�
E-Mail: Phone No. 772-Y6S_- 76
Fill in fee simple Title Holder on next page(if different E-Mail: f`Ovwli?�c,- _-PP11kW_1+5_01 HoUYhal I rvor-1
from the Owner listed above) State or County License: CAG03766-q
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION 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 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:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the-first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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Sign ure of Owner L ee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF ��. .Z4,C,,�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2,,,Wday of Age 20/,I-by this Z2dday of 20 /7 by
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s em,U T D�.I�6m � (Aid �,� tAlo l
(Name of person acknowledging) (Name of person acknowledging)
�-I/-- C-L51 (l(�i' &-/"
(Signature of Notary P lic-State of Florida) ( ignature of Notary P ic-State of Florida)
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. —T �•; �a 2 `f Commission No. � 07 ' 00
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REVIEWS FRONT ZONIf�E�/lIIIh,` VISOR PLANS VEGETATION SEA TUR A 0 fl lQ of cbVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW /ItI &glll21%IEW
DATE
COM P LETE
INITIALS
Page No. of Pages
Proposal
ADVANTAGE AIR CONDITIONING OF THE TREASURE COAST, INC.
" State Certification No, CAC039664
--=rA-
opt Service On Any Make, Any Model
J 601 South Market Avenue
=465216��06 (172)
RCE, FLORIDA 34982
335-3339 Martin County
1-800-232-1817 M-F FAX 772 465-4945
PROPOS ED TF'() PHONE DTE
STREET JOS NAME
Zj '2.,2.1, �w�.r•5 e �'l>�
CITY,STATE and ZIP.�C.-D�E^ JOB LOCATION
ARCHITECT DATE OF PLANS JOB PHONE
We hereby submit specification and estimates for:
. 3-�, �b •Se�,r-
e�r;f,.�.�. ;gid--,��� �s-D�� �� Sk.��- �► .��..�: —�-5��
i?Vrjopaa-herebX to fumish material and I bor-complete in accordancewth above specifications,for the sum o
16
2t dollars($
Payment to be made as follows:
Ail ma#erial is guaranteed to be as specified.All work to be crompieted in a warkmaNike manrrer Authorized
accordingtostandardpractices.Anyaltera'onordeviationfromabovespecificationsinvolving Signature
axis costs wilt be executed only upon written orders,and w 11 become an extra charge over 9
and above the estimate.All agreements contingent upon strikes,accidents or delays beyond
our control.Owner to carry fire,tomado and other necessary insurance.Our workers are fully N f1i5 proposal maybe
[Da
oeed by workmen's compensation insurance. hdrawn by us if not2ccepted.within days.r 1tatt C>2 Of%)rOP00rat-The above prices,specifications
onditions are satisfactory,and are hereby accepted.You are authorized Signature
the work as specified.Payment will be made as outlined above.
of Acceptance: Signature