HomeMy WebLinkAboutBuilding PermitALL APPLICABLE(I,NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10 /-U Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing
Address: U UJ t II (-A V _1C_ T► J l
Legal Description: i A rfyc)�'C
Property Tax ID #: ` Y—I Ik-1 _ �)';,J
Site Plan Name: MOQy_
Project Name: Clu r_0
Setbacks Front Back:
LIKE FOR LIKE HWH CHANGE OUT —
Additional HVAC work to be pe G rmaunder this
nk �
1-1 Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ ( 0 2 ° (00
Na
City: — ( )`fir (.`' Stat
Zip Code: 44
Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if diff
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED
t — check aii tau � appiy:
iping _ Shutters
Hers ❑ Generator
S. of First Floor: _
Utilities:] Sewer F]Septic
FL
Lot No.
Block No. L
oWindows/Doors
0 Roof
Building Height:
Name: ALAN LaFOY
Company: EAST COAST MECHANICAL
Addraw 1500 N HIGH RIDGE RD
City: BOYNTON BEACH State: FL
_ Zip Code: 33426 Fax: (561) 493-2701
Phone No. (561) 586-3739 EXT 2020
F -Mail: PERMITS@ECMSERVICE.COM
State or County License: CFC048260
of Commencement is required.
NO 0,
FRONT
COUNTER
.
Infi°t
IX . e ''l
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
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:
INITIALS
Name:
Address:
Address:
City:
City:
Zip: Phone:
i
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 your Notice of commencement.
Signature of Owner,
STATE OF FLO
COUNTY OF
The f r oing instrument was acknowledged fore me
this day of < �1,��) 20 _ by
H L
(Na e fe(son acknowledging) ��4'
�1 q ct,�0�,
(Signature of Not�r j Public- State of Florida )
Personally Known X OR Produ
Type of Identification Produced
Commission No
Revised 07/15/2014
A /��
Signature of Contractor/License Holoir
STATE OF FLORIDA
COUNTY OF PALM BEACH
The fgFgoing instrumen yeas ack wledged efore me
this JA da of r- _1 t 20 y
ALAN LaFOY h�
(Name of person acknowledging) 'e ���4�1,
I � •\y5 Oho ��
(Signature of Notary Public- e of Florida)
Personally Known x OR Prod u Mett`~i-at�oii
Type of Identification Produced:
?2'•
fir•• � .
Commission No.
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS
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