HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ) t� 7
Date: CO. T - l s ' Permit Number: / S-OA.ya /
Building Permit Application SC BY tL
Planning and Development Services St. Lude Copooi.
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial 146Residential
PERMIT APPLICATION FOR: Mechanical III
Address: 6') d ?i I LC'C.a ) l L iia,CijeK 1-4Ve
Legal Description: _ t f\A is4ie t 0 S/ b L-o '- L e-6 s S aQ Ef
Property Tax ID#:Rq 'IO JDo� 6pD% b00C Lot No.
Site Plan Name: /� TMU
Block No.
Project Name: 1 e 0/L7 y' gejI
Setbacks Front Back: Right Side: Left Side:
tDETAIC�D DESCRIPTION CIFiWORK. "' ;,' , .. " `t>r\ x;, r'Wd
�_ko� w`t_� �- CD(Utea Lf\b —11p
L 1 `A"
COIVSTRUGTIQN:INFORIVIATIONra
itional worK to e e orme un er this permit - c ec a apply:
❑✓ HVP 11 Gas Tank E]Gas Piping- _ Shutters ❑ Windows/Doors
Electric 0 Plumbing .Sprinklers ElGenerator E]Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
�/"^ Ob �j
Cost of Construction: $ 1 W Utilities: In Sewer Septic Building Height:
OWNER/LESSEE: - r
CONTRACTOR;
.'
Name
ame:
(1ll;LS
Addres : SW
K
ompany: GRIMES HEATING AND AIR `S
City: -state:FL
Zip Code:.3 3 3 Fax:
Phone No.
Address: 3054 N US HWY 1
City: FORT PIERCE
Zip Code: 34946 Fax:
Phone No. 772461-8711
State: FL
772-461-8722
E-Mail-7N.J2 (3_X-aKN
5P)Q)Ci D\ i C=
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: shannagrimesac@aol.com
State or County License: y
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL'CONSTRUCTION LIEN LAW INFORMATION.,
DESIGNER/ENGINEER: x Not Applicable
Name:0 Gamic 3 Svbso4ti
MORTGAGE COMPANY: x Not Applicable
Name:
Address:® " 31 s7—
Address:
City: ® t-i i cr State: t_
Zip: 13ti95a Phone: mW-7-. (e11 4(. 7
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: x 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.
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 jobsite
befoTIMV first inspection. If you intend to obtain financing, cop8q with lender pr an attorney before
corntriending work oxPcoxda"ie vour Notice of Commencement£ /
of Owner/ Arent/ Lessee
of Contractor/License Holder
STATE OF FLORIDA / _ STATE OF FLORID/��
COUNTY OF ,�F. �LL�� COUNTY OF •lGe
The forgoing instru ent was acknowledged before me The for oing instrument was acknowledged before me
this � day of b�/ a�L /�� t-P , 20 �by this day of O/ 2041by
J�ri'I e5 L°n�es _ CLI?'leS �j�i�e5
(Name of person acknowledging) (Name of person acknowledging )
(Si ature of Notary Public -State of Florida) (Signs re of Notary Public -State of Florida )
Personally Known L1___`OR Produced Identification Personally Known OR Produced Identification
Type of Identification
Commission No.
Revised 07/15/2014
of
tarSANDRA y Public -- Stotary Pub g to of Florida
a e of F�orl2a �ssion No. ` �' �� NyCommissioncto$ 14.2018
Comm. Expires Mar, 1A 2010
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