HomeMy WebLinkAboutBuilding Permit Application 11/27/2017 17:57 7724626448 SLC CODE COMP PAGE 02/03
11/27/2017 15:43 77246120'136 STEVE SMITH AC PACS 02/03
i
ALL APPLICABLE IN M BE CWPLFMO FOR APPLICATION TO BE ACCEPTED
Date: L(_S_,S(P
Permit Number: rl
i
Building Permit Application NOV 2 8 2017
Planning and Deve1apmvnt5uWws
80dhg end Code RepuladanOFvlalai PER"JI�'TTI�JG
23WVIrginivAvenue,FortPknvFL)498Z St. Lui�County, FL
Phone:(772)462-1553 Fax:(Trt)462.1578 Commercial Residential
PERMIT APPLICATION FORv To Select frorr1 drapbax,dick arrow at the end of line kk 14V Ku
Address: 6f�d/ i4•.j
Legal Description: .
Property Tax ID#: ��/2'—��, - �rc��4- 44p-� ._ Lot No. z:F
Site Plan Name: Block No.
Project Name:
Setbacks Front Back Right Side: Left%Je:
AdWtional Work to rme an r srm _c eCK211app .
HVAC Gas Tank s Pip)ttg 1:1_Shutters Windows/DGbors
Electric Plumbing 5prink[Ers Generator Raaf F;aof pitch
Total Sq.Pt of ConStructlan: r/ 5 .Pt.of First Floor:
Cast of Construction.$--�'�--i ltltilities:]Sewer septic Building Fleigh#:
Name av Name: Eum smith
Address: gorAM/�i'r G•� fi Company: Steve SRO AirCondlnorting
Ow. �rrY� ___ state:�� Address:8001 Eaten Road
Zip Code: Ty rj Fax- City.City:Fort Plerm Y str*&L
Phone No. �Wd- 3&l1~ZY� _ Zip Code;34951 Fox.772461-M
E-Mail: i Phone No,T72 X81^1425
Fill In fee simple Title Molder on nit page(if dl"nt E-Mail:1&teve6rtdit0QWXQrn
from i11te Owner Lister! above) State or County License: GAC7a13454 ,ZM71
H value of ConM,dbn b$ZSW or mare,a RED Notice of=rnancement is requbvd.
11/27/2017 17:57 7724626448 SLC CODE COMP PAGE 03/03
11/27/2017 15:43 71246129:1:6 STEVE SMITH AC PAGE 93/03
DESIGNER/ENGNEER: Not App ica le MORTGAGE COMPANY. No#Applicable
Name: Name:
Address: Address:
City: -I_State, City: State:
Zip: Phone: Zip: Phone:
FEE SAMPLE TITIN HOLDER: �C Not Applicable BONDING COMPANY: -X-Not Applicable
Name: Name:
Address:
Address:
City: City:
4p: Phone: _ Zip: Phone:
I certify that no work or installation has c,j>mmenced.prior to the issuance of a permPt-
St_Lucie County,makes no ra resentailon hat is granting a permit will authorize the permit holder to build the ubject structure
which Is in corMiet with any hppficable Ho a Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Jwners 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 ail respects,perform the work
in accordance with the approved plans,ttn,B Fkorida Building Codes and St.Lucie County Amendments.
The following building permit app licationslare exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fenzes,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Carnmencement 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 initend to obtain financing,consult with lender or an attorney before
commencinit vwrk or reomndjt&yoL r Notice of Commencement.
S
Signature of er/Lessee/Agent Signature of ractor license Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The fo)1going insxrument was acknowledgitd before me The forgoing instrument was acknowledged before me
this_j— day of 'JUn t 201 is-by this J day of Mt 20 _!S_by
_.��._Ca���w ..+r,.,____�--- r/` �C�QrC .�r►f�r�
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida} (Signature of otary Public•State of Plorfda)
Personally Known OR Produced Identification Personally Known__21_OR Produced Identification
Type of Identification Produced 1 Type of identification Produced
Commission No. (Zo) ` ission Noff l5lu1 (Seal
HNain�raanwla
STATE OF DA NOTARY P1 SIX
6iA E OF M400A
Revised 07/15/201 w4v9"M19 Canvi*FM1212
5M712019
REVIEWS FRONT ZON114G', SUPERVWR PLAINS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW RtVIEW REVIEW
DATE
COMPLETE
INITIALS