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HomeMy WebLinkAboutBuilding Permit Application NIay.23.2018 05:17 PM ACT Heating & Cooling 7728126250 PAGE. 1/ 4 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: - � ELuae CEIVED Building Permit Application Planning and Development Services 2 4 2018 Building and Code Regulation Dlvislon unty, Permitting 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 .PR 0 o' f r.1 � 1.1 ti -' !C!: Address: p l In 1,rm e Lctoe- Legal Description: 4 Property Tax ID M J' 000 ' Lot No.. Site Plan Name: Block No. Project Name: _-- Setbacks Front Back: Right Side: Left Side: 011 f U" cam, =�s�inc� iCQQP-y�''i�l C +-.a� -Tdr, `�ra�� �q 5 r 5K�1-•/ ` c'3OGjcoo H G A '2 41o20 1 rZE Ton -T—Y'a^�- NS�r �, `�, �I 1. 1J ,v v g r��� 1ry "A eWU1rnYMt."'..n>e ona worK to ff rorme aner s perm -cec a app y: HVAC Gas Tank ❑Gas Piping Shutters ❑Windows/Doors U Electric Q Plumbing ❑Sprinklers CGenerator Roof Roof pitch Total Sq. Ft of Construction: Sci. Ft.of First Floor: Cost of Construction:$ 00© _ Utilities= Sewer O Septic Building Height: 01 IN T Name bra F-f-n l e\'l Name: �t5rc>latr�- '-d S a Address: °I(ol(o (Ctnge Shck. L.on Company: C- C-00L c city or-1— Ll,�s,,�n State:E Address:�[ea 5LJ it, LL,6 c aw( 4 Ca Zip Code: 3 9$(Q Fax; City:3oLut',& State:-FL Phone No.7q 2R-j :1 ;a(i q Zip Cade:'5q0 5.73 Fax: E-Mail; Phone No. F5 a FIII in fee simple Title Holder an next page(if different E-Mail: cao G C0M from the Owner listed above) State or County License: cg )eI got'o If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required. May.23.2018 05:18 PM ACT Heating & Cooling 7728126250 PAGE. 2/ 4 's,LP, .�,'A�M'��� k, i. �� d^��r , r'•� ,� p fit�.. 1P•F5/T���r ,,'.�'� lr 7J�C" r J `nr, DESIGNER/ENGINEER: X 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: OWNER/CONTRACTOR AFFIDVIT:Application Is hereby made to obtain a permit to do the work and Installation as Indicated. 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 an yy pplicable Home Owners Assoc atlon rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult w`t�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. s4natdre of Owner/ see/Contractor as Agent for Owner Signature of oniiactor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF„ nCOUNTY OF �- . L IL,e The forgoing Instrument was acknowledged before me The forgoing Instrument was acknowledged before me this I,day of M A...__.. ._ ,20is— by this lE day of LngA 2Q_ by Name of person making statementaamme�of person making statement Personally Known ✓ OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Type of Identification produced Produced a u ( ature of Notary, - ate I�1 NIGHT JENNIE KNIGHT mis ibi r «t N#GG1( Ii Commission No. �` '�= MY COMMISSION# G135511 EXPIRES August 17,2021 PIRE8 Au �� ,2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev, 8/2/17