HomeMy WebLinkAboutDiIorio Jim mini-split permit application08162018ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal Descriptions
Property Tax ID #: �3l "��'(� Lot No.
Site Plan Name: Block No. _1 '1
Project Name: 4 yej
Setbacks Front Back: Right Side: Left Side:
i� ►� ��,� Clue+less i11� hi -Sp � ,��- �C�n�' —
i�s�tl�ish��St�32-
ectric
0 Plumbing
Total Sq. Ft of Construction:
7
Cost of Construction: $
Na
0 Sprinklers
L _,J Shutters
InGenerator
S�Ftj of First Floor: _
Utilities: ]Sewer 0Septic
Name:
Company:
City: YT iState:,I1 Address:
Zip Code: 'Z— Fax:- _ City: CI
Phone No.'_1 iZ`34jC Zip Code: 34q
E -Mail: Phone No. 7
Fill in fee simple Title Holder on next page (if different E -Mail: r l
from the Owner listed above) State or'County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Windows/Doors
Roof
Building Height:
Roof pitch
Fax:%?Z 3 % 7Z-7
b rV1
DESIGNERANGINEER:
Name:
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:—
State
- Not Applicable
MORTGAGE COMPANY:
Name:
Address: _
City:
Zip: Phone:
— Not Applicable
State:
BONDING COMPANY: Not Applicable
Name:
Address:
City:_
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 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
commencing1work or cording our Notice of Commencement.
3 Jf
Lessee/Contractor as Agent for Owner
1`01` FLORIDA
NTY OF �'L0 e.
The forigging Instirturientiwvs acknowledged before me
this Ndayof 20±1 2C, by
Name of per sop making statement
Personally Known ✓✓ OR Produced Identification
Type of Identification
Contractor/License Holder
$TATE OF FLORID��yj jj� � �a
COUNTY OF Wit' l l.,l' Ci e 1..6 .
The forgoing instr ment was acknowledged before me
this day of 201 by
Name of perso�rraking statement
Personally Known OR Produced Identification
Type of Identification
CRAIG A. GRCi
y C i
SMAN ;F•(' ^lid: CRAIG A. GR
ti9Y COMMISSION
FF990902� y •; MY COMMISSION
(Signature of Notary Public- State
r=XPIRES Mar
'agnatu a of Notary Public- State
i
Commission No.
(Seal)
Commission No. (Seal)
PLANS
VEGETATION SEA TURTLE MANGROVE
REVIEWS
FRONT
ZONING
SUPERVISOR
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
_
COMPLETED
Rev. 8/2/17