HomeMy WebLinkAboutBuilding Permit Application 01/18/2018 09:26 Lindquist Plumbing 7724611999 N0.338 #001
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date= Permit Number: 1 O c�
LRECEIVEDIBuilding Permit Applicatio8 201Planning and DevelopmentServices Building and Code Regulation Division tY, Per
2300 Virginia Avenue, Fort Pierce FC 34982
Phone: (772)462-1553 Fax: (772)4b2-15/8 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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: .:-:•.,r.--. .,. .7 S�Ittkitld(NlAinf:i '` .ten,. 1�
Address: ,5�/
Legal Description:
Property Tax ID tt: / —`;� rte'-000 2.-000—.Z Lot No.
Site Plan Name: t� .� Block No.
Project Name:
Setbacks Front Back: Right Side: _Left Side:
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Additional wor<to a er orme under this permit—c ec a appy:
HVAC Gas Tank ❑Gas Piping _shutters ❑Windows/Doors
11 Electric laolumbing OSprinklers 0 Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ i7�?Q Utilities:"tSewer Septic Building Height:
�° Mw T , �0
Name _�6Ez ...... Name: Z_/.�.o Q//Jr
Address: 9?oCompany:
City: /°iE2(( ' State:IC Address:
Zip Code: Fax:___ _____ City: IZnP` /!7QW(c State-
Phone No. Zip Code: 3 22 y7 Fax: 61, z 9f
E-Mail: Phone No. �'16l f 96 rJ
Fill in fee simple Title Holder on next page(if different E-Mail: G
from the Owner listed above) I State or County License: CFC ��f 2.Yy
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
01/18/2018 09:27 Lindauist Plumbing 7724811999 N0.338 #002
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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,
accassnry 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.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLOR14A
COUNTY OF 1'"L UC/C COUNTY OF J F-(—Cj /C
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of :24: 20/ by this zL-day of ,T 20/1x_by
(Name of person acknowledging) (Name of person acknowledging)
glFw-
(Signakure of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known LI"-- OR Produced identification Personally Known �_OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. MICHELECT _— (Seal)
Ri s-
;'e MY COMMIS ION 0 GG055253
r2-,2020
hevised 07/15/2014
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