HomeMy WebLinkAboutBuilding Permit Application Dec U318.81:5Dp Advantage Air 7724654945 P2
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: lallp) Permit Number:
Building Permit Application DEC 0 3 '('018
Planning and Development Services ST. Lucie County, Permi]ing
Budding and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residenfial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line (3x,
Legal Description: 011,�(
Setbacks Front�-_ Back:_Right Side: Left Side:
I-rtQE T 9 1 E�i��IPTICI OF-WORK: - -
--A-dditional work to be erformed unde this permit—check alPtfta apply:
[3HVAC Gas Tank []Gas Piping F15hutters W(ndows/Doors
13 Electric Plumbing OSprinklers Generator 0 Roof' Roof pitch
Total Sq.Ft of Construction: SQ.Ft.of First Floor:
Cost DfConstruction:$ Ili Utilities:0Sewer Septic Building Height:
State: rC- Address: 1"01 -&f-
Zip Code: 3Y9�� Fax: 0 IA- City:iror4- Pe&e- State.-Z-:?,
Phone No. W4 Zip Code:
Fill in fee simple Title Holder on next page(if different E-Mail:Ad
from the Owner listed above) State or County License: 4$3 te to!
Dec 03 18,01:58P Advantage Air 7724654945 p.3
�SUPRLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGN ER/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: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone.
OWNER/CONTRACTOR AFFIDVIT.Application is hereby made to obtain a permitto 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 thepermit 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
ornmencinx work or recording your Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA43 I STATE OF FLORIIDJtS_�S
COUNTY OF COUNTY OF
Th.e forgoing in ment was acknowledged before me The forgoing instrument was acknowledged before me
this �day of
-)A IQby this day of IN 20ja by
3�Mug--1 —T
Name of P king statement Name of per f on making statement
r� rso ME/ Known OR Produced(dentifficatio
Personally Known n Personally Kn4
,_�(OFJ -
Type of Identification Type of Identiflc;Kon�
Produced Produced
grim
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9 W M
(Signature of No&q f1dSMeoFlorida) (Signature of N imrMff-lorida)
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Commission No. (Seal)(Sea[) I Commission No.600-9&20159 (Sea[) 6'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17