HomeMy WebLinkAboutHIRSCH HEATER APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
L Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 7%'88 '12Z 7-;97-/z /J L.f}f«S 2W - l°lt st Lucle _-3' Z9,
Property Tax ID #: .J��v� ' zy'DLot No. 17
Site Plan Name: �/�{.s�i/ _ _ _ Block No.
Project Name:
I DETAILED DESCRIPTION OF WORK: I
/(lea 1�k�
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/, - .�/Y9.o-r Al�af I��i� of
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
%Mechanical _ Gas Tank —Gas Piping _ Shutters _
V Electric _ Plumbing _Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
00
Windows/Doors _ Pond
Roof Pitch
Cost of Construction: $ �O d4 . Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: 1<2M111
Address: % !S'� a ���e5 bf
Company: `/- ��GS
City: � z 5t Ll/'—/'e_ State: 1'-
Zip Code: Fax:
Phone No. ��.3 ' y�J� ' O;��i
Address: � �
City: iZG� State: /L
Zip Code: T/% / zl/ Fax:
�
Phone No
E-Mail: X///'s'--
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License '�2�4f
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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
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.
4n 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
commencing work or recording your Notice of Commencement
Signatu f Ow r/ essee/ ntrac or as Agent for owner
STA E OF FLORIDA
COUNTY OF
The for giog instrument was acknowledged before me
this day of Z44by
✓a seP� 1//.PSny
(Name of person acknowledging )
(Signature f Notary Public- State of Florida )
Personally Known
Type of Identifical
Commission No. G6
Revised 07/15/2014
OR Produced Id ntificationy
. YgJctavgip S of Flo
/J M Aey
rl-111
miGG 2801
F FLd Expires 11128f2022
Signatu
STATE OF FLORIDA
COUNTY OF
The forg instrume was acknowledged b//efore me
this day of 20 v/ by
(Name of person acknowledging }
(Signature Notary Public- State of Florida )
Personally Known OR Produced Identification
"1i6t5e of Identification Produc�'�
�s;" p; Nctary PUiAC')ML—. or r10f!M
GG l r tUlmd�y
rnsssion No. D mission GG 280148
'r nil,
E;;pires 1112&2022
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