HomeMy WebLinkAboutBUILDING PERMIT APPLICATION Feb 0720222:10pm LOU IE'S'AIRCONDITIONING 772-429-5267 p.1
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED .
Date: Permit Number:
RECEIVED
llo LUCll15 =R
a s �; FEB Of 7 2022
P D, ° _c D O�, Building Permit Application
st,LuQi��buf>ty
Planning and Development Services P1etl Ifi9
Building 9 and Code Regulation Commercial Residential �c
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 1166 i -
Property Tax I#: 9C,21, D 1) Z) .5 Lot No.
Site Plan Name: LL%I �r Block No.
Project Name: GJl -
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank - _Gas Piping• _Shutters' Windows/Doors Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
D�
Cost of Construction:$ y0� — Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name 'rEp )am,1>r 21'a. f— Name: Lb q f'S I.. A C
Address(:��%�G�� �t �ciC3(7� 1i.1� Company: _L.l U/EIS ao(q
City: +T N-'i i� �� Stater. Address: dot 3S vc i—f� - '� t
Zip Code: 3 Fax: �-- City: i ' J7- L c)e (e State: �L
Phone No. 772 577 L./5 E- Zip Code: 34 CJ50 __Fax:
Mail: Phone No 7 7-- 3-36-- 76 71
Fill in fee simple Title Holder on next page(if different E-Mail Lf)L. 1 E5 -- 41
from the Owner listed above) State or County License C/A ob n�73 7�
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.
Feb0720222:10pm LOUIE'S AIR CONDITIONING 772-429-5267 p.2
SUPPLEMENTAL CONSTRUCTION LIEN LAW.INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address:. Address:
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 the permit holder to build the subject structure
which conflic&with any applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Homeowners 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 paying twice for
improvements to your property. A Notice of,Commencement must be recorded in the public records of St.
Lucie County 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 our Notice of Commencement.
ignature C ntractor-or-Owner Builder as applicable
STATE OF FLORIDA _
COUNTY OF 7 LI!CI E
Sworn to(or affirmedJ and subscribed before me of Physical Presence or Online Notarization
this_�7dayo/f ,� r✓U 204by
L1i
Name of person making statement.
����annrri,, -
rr Denise Lopez
Personally Known _OR Produced Identification 0%. .. •.
Type of Identific tion Produced • : cdglnl.X1//'Z1, MH113194
;€ Exppl�es'Mayg6,2025
Bonded Tul,Rn Notary
(Signature ota�ryJ A je 7 ealic-eta ,/�of FI ida)
Commission No. /V . ri l )
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE .
RECEIVED
DATE
COMPLETED
Rev 10112121