HomeMy WebLinkAboutBuilding Permit Application 08-30-'18 15:15 FROM-freedom air & heat 3216316869 T-127 F0001/0004 F-289
ALL APPLICABLE INFZ MUST BE COMPLETEI)FOR APPLICATION TO BE ACCEPTED q
Date:
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Building Permit Applicatio
Planning and Development Services
Building acid Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 '
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential ILL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address
Legal Description. (�, C" {-7—,3
Property Tax 1 D#: "�3�a`' b 1 0 ��-d CS 0-3 Lot No.
Site Plan Name: YY�ft,S cih�e. �.�C, rl l 1.� BlbtkNo.
Project Name:
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r=JHVAC []GasTank ❑Gas Piping _. Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq.Ft-of First Floor:
Cost of Construction:$sVe 0 a U U Utilities:0Sewer OSeptic Building Height:
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Nam Name:
Addre s: � Company: o t
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State: L Address
Zip Code,. Fax; City: (a It „__•^,^_ State:
Phone No. „ J�N o Zip Code: 3Q q )Q Fax:3a177 6 3h'?D�C��
E-Mail: ltYnmA_�n.11 r.r�tilii�kar!n-1- Phone No _J"'_� ♦' - , (j�J ,_ �^
Fill in fee simple Title Holder on next page(if different E-Mail: f'.
from the owner listed above) State or County License. µ
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
08-30-'18 15:16 FROM-freedom air & beat 3216316869 T-127 P0002/0004 F-289
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DESIGNER/ENGINEER: ^Not App a MORTGAGiE 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 ermit holder to build the subject structure
which is in conflict with anyapplicable Home Owners Association rules,bylaws or an9covenants 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,l do hereby agree that l 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,
Signature of owner/Lessee/Contractor as Ag nt for owner Signature of Contr ctor/License Holder
STATE OF FLORIDA 5.j. �.uc��`e. STATE OUNTY OFORIDA Lucre
COUNTY OF %%��
The ng nst_r_um_lint was anawiedged_beefore me The forgoing instr ent was acknowledged before me
this pdayiof fi � J this day of 20 idbbyrrg
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Name of person making statement Name of p rson making statement
Personally Known_ K OR Produced Identification� Personally Known .4 OR Produced Identification
Type of identification Type of identification
Produced
Produced
Signature of otary Public State of Florida} {Signature of Notary Public-State of Florida J TRAVIS SAX I
TI S EIA! IiSLW £ l'Aft 4'U
Commission No. i' kt1 tYPlll
mission No. a• ya'Ks ov:F A
6TATE OF 10A
91
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REVIEWS FRONT ZONING SUPE VISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17