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HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 6-a�'�Qad Permit Number: Building Perm it.Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: PROPOSED IMPROVEM Address: J//� 44� Property Tax lD #: �7 a'�` - -GAS CO Lot No. Block No. Site Plan Name: Project Name: DETAILED DESCRf1 ©N 0F.�#OM Me- CONSTRUCTI©N NFORMATIO Addit�nal work to be performed under this permit - check all that apply: I/`. Mechanical _ Gas Tank _ Gas Piping _ Shutters Electric — Plumbing _ Sprinklers Total Sq. Ft of Construction: _ Generator Sq. Ft. of First floor: Windows/Doors Roof Pitch Cost of Construction: $��� ' Utilities: _ Sewer _ Septic Building Height: OWNER/LESSa: 17CO.NTRA£TOR; . _ , Name a �cLfi1l�/C� l��a 5 Name: Curtis Sammons Address: ��ll� �d�ir� ���G �w ��% Company: Custom Air Systems, Inc. City:State: � I Address: 1615 SE Village Green Drive /��,�z,�i�l'l� Zip Code: Fax: ' City: fort Saint Lucie State: FL Phone No. ���- i��v2- Zip Code: X952 Fax: 772-335'1968 E -Mail: Phone No 772-335-3232 Fill in fee simple Title Holder on next page ( if different E -Mail custairsys@aol.com from the Owner listed above) State or County License CAC051810 I If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. 52546 Ess SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address.- ddress:City: 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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOU11t LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." 0. S7 Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA�T . p COUNTY OF S,6 oLU'-' _C' STATE OF FLORIDA COUNTY OF t/� r� 9�L_ The forgoing instrument was acknowledged before me this ,Zf day of 02?40 20 d,' by The forgoing instrument was acknowledged before me this _,2?day of 20 02 4') by ('(k t? 77S n1X0ns eu'qTIS S/3Pr1/V i Name of person making statement. Name of person making statement. I Personally Known OR Produced Identification Type of Identification Personally Known OR Produced Identification Type of Identification Produced Produced (Signature of Notary Public- State of fforicla } 0,1StY Pt* t ^ D 5 S�� i •.f CHRISTINE B EN 4e, Commission No. MY COMMSSION I G EXPIRES: APra 4, (Signature of Notary Public- State of Flori of ; �Oet CHRISTINE B ENG r n fission No.mCOI!A/ISSKN4 G 21 EXPIRES: Apd rn�� gy REVIEWS FRONT ZONING SUPERVISOR PLANS [VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW i DATE RECEIVED DATE COMPLETED Rev. 52546 Ess