HomeMy WebLinkAboutBuilding Permit Application 11/30/2018 10:32 Lindquist Plumbino 7724811999 1,10.923 #002
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 q
Date: 3d Permit Number:
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RECEIVED
Building Permit Application
Planning and Development5ervices NOV 3 ® 2013
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie o n PennItt
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Res identia
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Property Tax ID#: "7 ]M) " ( F J L-' Lot No.
Site Plan Name. Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additional wor o e ertoormed under this permit--cneCK all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doers
Electric 0 Plumbing U Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 5 Ft.of First Floor:
Cost of Construction:$ 1;i boo Utilities: Sewer Septic Building Height:
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Name Name: �.�,. _.
Address, II r Company: r
City: GT" V de, State: Addre
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Zip Code: Fax:_ City: ,�.. ) StatAq ,
Phone No.-1-1�" ? toy�- a-loo Zip Code: L .PIL Fax: 1 -
E-Mail: Phone Nod a'k-I l-J%q ,
Fill in fee simple Title Holder on next page(if different E-Mailt_�MC `iii on
from the Owner listed above) State or County License_l,n
if value of construction is$2500 or more,a RECORDED Notice of Commencement i5 required.
11/30/2018 10:32 Lindnu|ot P|umh|na 7724611888 HO'823 #003
DESIGNER/ENGINEER: Not A N ble MORTGAGE COMPANY: Not Applicable Name: Name:Address. Address:City: state: City: State:Zip: Phone Zip: Phone; 1!��FEE SIMPLE��DER: Not Applicable 'BONDING C Not Applicable Name: Name:Ci City:zi Phone-, Phone:OWNER/CONTRACTOR AFFIDVIT,Application is hereby made to obtain a permit to do the work and installation as Indicated.I certify that no work or installation has commenced priorto the issuance of a permit.St,Lucie Countv makes no representation that is granting a permit will authorize the ermit holder to build the subject structure which is in conflict with any applicable Home Owners Associ2tion rules,bylaws or andcovenants that may restrict or prohibit such structure-Please consult with your Home Owners Association and review your deed for any restriction$which may apply.In consideraLion of the granting of this requested permit,I do hereby agree that I will,in all respecLs,peiform Lhe wurk in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.The following building permit applications are exempt frorn undergoing a full concurrency review:room additions,accessory structures,swimming pools,fences,wails,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 NoticL 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 ommencinp,work or recording your Notice of Commencement.Signature of Owner/Lessee/ConLeactor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORI STATE OF FLORIDA , I COUNTY OF k L,&I COUNTY OF 51- ALL)a 1 12Th q ping instKrn t was acknowledg-ed before me The for ing instrument was acknowledged before me NameofpQr5o making statement Name foersonmaking statement Personally Known Y K OR Produced Identification Personally Known X K OR Produced Identification Type of Identification Type of Identification Produced Produced tu N a te o Florida) (Sig t4e of Not@ Public-S ate of Florida)MY OOMMISSION 00 171078 my(;Omm GG 171M Sonded REVIEWS FRONT ZONING SUPERVISOR PLA S MANGROVE COUNTFIR REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED - - _--