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HomeMy WebLinkAboutBuilding Permit Application 12/26/2018 WED 10: 47 FAx IZJ004/007 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Rate: IQ-a CO.—L$ Permit Number: I ic/i a' 0 1ac,:ieM�nnrxe,rnuna:m'n.n,�r.:A,xlu,4N'F Building Permit Application , Planning and DeVeloprent Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax:(772)462-1578 Commercial _ Residential xxx PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line r, ....,uu,Fr .-,--..,� i , .'ril. l� ..._1Yv...F..X,5 r•:.....,d L,e1,.1S.....1 .y r, ..a c9e,`r i, .I .i .,,••,; - �,i,,v.l.,..t r. .r it... ,I I .t, , ,z .-._. .,. .....,� � , .,*:„�iT.A 'i"I: ,. ,,;7,':,,,..• .I ,}£,:< -.,;t.t Y;� 'i: .il: 3;� „1* :tl �., ,t ^u': c . ., , -.�, ,,,�' .,1. ,bi I i..r:is .�f.L ii ys i. . 4i,,},., rr,•. 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I,nc•:i. �• � �'a: �!- i.�:.! d.;.Fay £::.;{ �, . 9 ' .n•? t , a 9Y_ dR `} . � 1 ',n�IrI. ,,.., 91:1•,t;r 's-.i-rU�::u..,:i ,' ( 4i, llR„ }T7i' ;, 8a,.'..+l;x1, ,IL: ,t , ,, '9i.df1 NameJohn F Francis - Name; Jeffrey Lindstrom Address:7814 LONG COVE WAY Company: Lindstrom Air Conditioner ' City: Port St Lucie I State: Fl Address: 3581 W MoNeb Rd Zip Code: 34986 I Fax: City: Pompano Beath State:Fl Phone No.954-562-3292 _ Zip Code; 33069 Fax; E-Mail: 1 Phone No. 772-600-4088 Fill in fee simple Title Holder on next page(if different E-mail: dulcem@lindstromair.com from the Owner listed above) State or County License: CAC055971 If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required. 12/26/2018 WED 10: 47 FAX E10015/007 I ..b.YI .r. 1, � ��,"�" .:'.t" ",4 ..a.._.Y... .Si t. W`'�: i A;tf:..�;4. ,•.(:!`�._.,,.. 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DESIGNER •ENGINEER; _Not Applicable MORTGAGE COMPANY: Not Applicable Name: _ Name: I Address: _ Address: City: State; City: _ _ State: I Zip; Phone Zip: Phone:-_- 1 -„ i FEE SIMPLE TITLE HOLDER; Not Applicable BONDING COMPANY: _Not Applicable 1 Name: Name: � Address;3581 W McNeb Rd Address: I City: - City: Zip: Phone: Zip: Phone: I 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 I 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. I 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 stru -s,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential Use WARNIN e TO 0 NER:Your failure to Record a Notice of Comme e ent may result in your paying twice for improve. ents . yo r property. A Notice of Commencement ► ust 0e recorded and posted on the jobsite before a first nsp/ction. If you intend to obtain financing, •nsul. with I rider attorney before commencing o •r retcordin�y. lal ice of Commencem-nt. Z. _ i Sig Orr r- •f Owner/Lessee/Contractor as Agent for Owner Signa ffe of Contractor/License Holder I I ST• t OF FLORIDA ST. E OF FLORIDA COi NTY OF COUNTY OF I, The going Inst . ment wa a knowledge�,before me The aoing Instr ment was - kno ledged before me this 1 dey of °i r_:` o • by thi a day o ,• , , Ail ,1,A ,20 by 1 i? Name of person ma ing stall ent Name of p r on makln.. statement Personally Known AA/.OR Produced Identlflcas, Personally Known OR Produced Identification Type of Identification rr pgLCEM �03g91 Type of Identification Produced ...u°ir }mesion#04 Produced yvPi DULCEMARTINEa ` heeMaY40�20Zt' it' ExP sr+ Commbelen#00403391 e” °' '1-'4^ � 7 A 'i 7- ¢,,;,. • D Des Mey 40,2024 y4ori�� ,I'PFOFt�(f`' wall= (Signature of Notary Public-State of Florida) (Signature of Notary Public-state of Florida) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT I ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER I REVIEW REVIEW REVIEW REVIEW REVIEW , REVIEW DATE • RECEIVED DATE ' COMPLETED Rev. 8/2/17