HomeMy WebLinkAboutBuilding Permit ApplicationMPi.E'CED FOR AFPI.ICATION TO BE ACCEPT
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Permlt Number"
ALL APP1-IG,
Date; �� '�?-C�.—
Bu�ld��►+�
Planning and Devd()Pment Servicesls€on
Building and Cade Regulation Div
230o V€rg€n€a AvenueFort Pierce 1
553 Fax: (772) 462-1578
Commerc'tad •.�.--
RBslde __�
Phone; (772) 462-1 �}i& hBre � � � -
dropbox,
RM1T APPU AT►ON PQR: To Select from S
Address: G Cl 1
tvl CL A'
Legal Description; Lot0.---
Property Tax 1D #;
Slte Plan Name;
prect Name: left Side:
Setbacks Front,�.w._._ Back: Right Side: _
❑ETAIIEbdtkRlPTION.Of WORK.:,
Cs3:N5T tUC TiQN iNF'Q ' ATION
tiona wor o e e orme under tnis permit— check all tha apply'.
0KVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
11 Electric Plumbing Sprinklers 11 Generator Roof
Total Sq. Ft of Construction: So. Ft. of First Floor:
Cost of Construction: $ 0 1 ( z Utilities: 11 Sewer Ej Septic Building Height:
Name e t
Address: Gl ��� � _� �V1
city. f pip �C�1 _ State' FL -
Zip Code: __'3eq 1, I Fax:
Phone too, :ICS— _ R j ,-- ,
E-Mali:.
Fill in tee simple Title Folder on next page ( If different
from the Owner listed above)
name: UON_„-fAiKt+'UJ --_
Company;
Address: LI,'' AIJ) #16b
City: %iet~ :; 1Lu c_' / cam.• state: FL'
Zip Code. Fax: 77a `87!
Phone No. 7X-2 ,6�/-II I
>=-Mail. OA2VYIA Cat. A"
State or County License: Cri' % `
If value of construction is $2500 or more, a RECORDED Notice of Commencement is regvired,
DATE _ JOB #
TECH:
INVOICE tt P
MIRANDA
NAFIr
y� SFRcET
PLUMBING • DRAIN CLEANING • AIR CONOITIONING • ELECTRICAL
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NAME,_..._.---•---""",�'_."__---__—
PALM BEACH MARTIN ST.WGIE INOIAN RIVER
561-S33.7905 772.263.3232 772-878-5123 772-562-9406
STREET
750 N%V ENTERPRISE DR. 9100. PORT ST. LUCIE. FL 94986
WEtSSITE: MIRANDAAIRCUNDITIONINGS£RVICES,COFA
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STATE Zip
uCEN is sCAC1416409 LIVEN&E ACFCl 4271:r
PH s VVK F C-MAIL
EQUIPMENT
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SUBTOTAL
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DIAGNOSTIC FEE (from above)
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Coupons �_�
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Other Discount _.-, „,,,,,•,,,,•
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TOTAL AFTER DISCOUNTS
S
MEMBERSHIP FEE
3
OPTIONS
5
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DEPOSIT --- ----
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TOTAL COMFORT CL1i8
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SAVIN05 TODAY 11
WORK QUT140FKZA710N - Wn..�I:AT•:k •4 y .::�'� ;, •, :.• .
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❑ I Declined My Mechanical Check And Warranty Associated With Repairs
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MZri'j Of 0-jr Clients �rijoy On Time Fronit-01-1-1a(, Service, Unlimited Emergency & Scheduled
Service. Includes a 15% Dirtaunt On All Service Repairs With Wholc HouSe Package.
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WORK PERFORMID TO MY 6ATMACTION •..
TO CI16T4511K'6 SATIVAGTION
❑ 16eelined My Club Agreement Today - - —^-
-? CO6h 5
tir
C] Enroll Me In My Club MorllboratVip Today $_ Per Month 8 Per Yea
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PAYMIFNT INFO CARA TYPE: MC Vlso •lIYIPiz Gsc 37d Palry Finonce
El credit card I $». 7 pL f♦
I 1 Lx :.7p19 5•sCur1N C�tl"
Name:
Address:
City: _ State:
Zip: Phone;
FEE SIMPLE TITLE HOLIER- _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:, Not Applicable
Name:
Address:
City:. State:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Name:
Address,
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Couniv rnake� no represe tatlon that is granting a permit will ut orlxe the permit holder to build the subject str cture
which is In conflict wit any applica�la Home Owners Association ruiesabyaws or anecovenants that may restrict ar prohiubit such
structure. Please consult with your Horne 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 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
before3lag first Insoectlon. �f you intend to obtain financing, cons �en4e>*ar_aq.attorney before
°Slgraeture of'4w6erl Lessee/Agent w -�
STATE OF FLO IPA '
COUNTY OF
The forgoing instrument was acknowledged before 1.92 r.
this_:?_,,i day of D: 2.0 4by !E .0 '9
Tutu ��r �
{Namepf person acknowle ding j ,� _..
Personally Known �`OR Produced identification
Type of identification Produced
Corrimissian No: _ �Y3�/ (Seel)
Revised 07/15/2014
REVIEWS I FRONT I ZONING
COUNTER REVIEW
INITIALS
STATE OF PLO ?�.
COUNTY OF t a-.
The forgoing instrument was acknowledged before m
this day of Z- C���'i� ,�, Zt] � by 2
w
Personally Known L�lO� Produced identification
Type of Identification Produced
Commission No. - — 2 � d-1 (Seal)
SUPERVISOR
I REVIEW 1 VEGETATION I S REV EW I
MANGROVE