HomeMy WebLinkAboutBuilding Permit Application Feb 22 02 06:03a South Par Plumbing, Inc. - I•(772)287-2559 PA
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 74 Ywoc
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1579 Commercial Residential X
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PERMIT APPLICATION FOR: To Select from dmpbox, click arrow at the end of'line
PROPOSED-IMPROVE MENT LOCATION,
Address: VNI D VU Oa( h4VNk �_. M 0%3v,I ,
9 , 16
Legal Description: Gti # 4GLZb ,r VIA942
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Property Tax ID#: - - - cm_ I Lot No.
Site Plan Name: n Block No.
Project Name: CbAcL F1 _
Setbacks Front Back: Right Side: Left Side
DETAI.LED,DESCRIPTION"OF WORK;
c � �►x�� 1oc�r,�s
fx��►,n VJ�e..� Clots _
CONSTRUCTIO. )NFC!' ATION:Acidsl
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Itiona wor to e e orme under t Is permit-c ec all apply:
�HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
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Electric QPlumbing Sprinklers Generator Q R lof Roof pitch
Total Sq.Ft of Construction: 11 ++ Scl. Ft.of First Floor:
cost of Construction:$ Utilities: Sewer F]Septic Building Height:
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QWNERJLESSEE; .,':.: CONTRACTOR;...: r
Name Name: SGSO!fl V�ll Sc�rl
Address: ) t-� Company: SOX% C l E-1m �
City: ONM ON State: Address: �b SCOX W6 r
Zip Code: �Q Fax: City:' 'ROC"kky-f a kI State:-VA
Phone No. Zip Code: FMIA2 Fax:9r) - ?& zo-5
E-Mail: Phone No. 2-2��'2rJ��
Fill in fee simple Title Holder on next page(if different E-Mail: VlCY1�J1 �lVe-COS
from the Owner listed above) State or County License: ��y2
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If value of construction is$2500 or more.a RECORDED Notice of Commencement is reiquired_
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Feb 22 02 06:03a South Pa lumbing, Inc. I(772)287-2559 p.2
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SUPPLEMFNTAL:CONSTRUCTIO.N•LIEN:LAW I:NEOR MAT ION.-:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: ! State:
Zip'. Phone: Zip: Phone. I
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
Address: Address: I
City: City:
Zip: Phone: Zip: Phone:
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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.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,peYform 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 Fender or an attorney before
commencing work or recording our Notice of Commencement.
Signa re Owner/Lessee/Contractor as Agent for Owner -�ig-tvre of Contractor/Eicense Holdler
STATE OF FLORIDA "�f STATE OF FLO A
COUNTY OF ..( '�,�tij COUNTY OF
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The oing instru e{i acknowledge�efore me The forgoing instru lent was acknowledged before me
this r day of J 20 J J�by this_day of _ ,20 by
.5Osan l arcb' 'm
(Name of per n i o 'sedging) (Na of person acknowledging) i
(Signature of Notary Public-S P d ��� {Signatur of otary Public S to of Florida)
Personally Known �0R Produ d i t{12in Personally Known -
Type of identif Type of Identification oducLe,�" l CHAD wINT7ftotawrv
�g��is�JB . � b �; Notary Public S
Commission No. (Sea Commission No. Corr( is94n 0
d � = My Comm.fxpke
,od `+nos s� �
goaded lhfouOr Nati
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Reprised 07115/2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE U ��
COMPLETE
INITIALS
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