HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO `MUUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z2J- T 1� Permit Number: /JVc} —0 occl—,
V � �
SCANNED
Building Permit Application BY
Planning and Development Services \ St. Lucie County
Building and Code Regulation Division l
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Mechanical III
I PROPOSED IMPROVEMENT LOCATION: III
Legal Description:\nd Ql0.Q S✓b Lt., -1-- -7 Less J F+
Property Tax IDtt:a4aSGDa 000-7 C>OCX-) Lot No.
Site Plan Name: Q 1 P2)7 I Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
III DETAILED DESCRIPTIOWOF WORK:` �7' ,.
`CONSTRUCTION INFORMATION:
❑✓ HVAC ❑ Gas Tank
❑ Electric E] Plumbing
Total Sq. Ft of Construction:
p Bo
Cost of Construction: $ A / &O
Piping "Shutters
nklers ❑ Generator
So. Ft. of First Floor: _
Utilities: Sewer�Septic
❑ Windows/Doors
❑ Roof
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Namen
Name: erne-5
5
Addres :6q-7 5
Company: GRIMES HEATING AND AIR
�(D_Q.
City State: FL
Zip Code: Fax:
Phone No.
Address: 3054 N US HWY 1
City: FORT PIERCE
Zip Code: 34946 Fax: 772-461-8722
Phone No. 772461-8711
State: FL
"�, P
E-Mail: DI.QO V 1t1 a
A f- S6P Cam
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:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: t_-fic 7 15go60aa
MORTGAGE COMPANY: x Not Applicable
Name:
Address: S}•
Address:
City: State: fi L
Zip: �_Z,46j 5t) Phone:(o-IZ- LALo:'9
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: �e 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
before t�hoi,rst inspection. Ify�eeqq intend to obtain financing, icponns t with lender or torney before
comm,6ncinla work or r@tor finahour Notice of Commencern6rit. /
Agent/Lessee
STATE OF FLORIDA5y_ / ..�/�
COUNTY OF Jz A GL
The for oing instrupte t was acknowledged before me
thisdayof 'NV &Y 20
li
'Cwie5 (7111me5
(Name of person acknowledging )
(S!97111re of Notary Public- State of Florida )
Personally Known FOR Produced Identification
Type of Identification Produced
Commission No.
Notary Public - Stab of
of Contractor/License Holder
STATE OF FLORIDA .
COUNTY OF — e.
The forgoing instrument was acknowledged before me
this � day of Fe�� 20�y
ljne5 d�m�
(Name of person acknowledging )
of Notary Public- State of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced
Notary Public - State o1 Florlda
Revised 07/15/2014 %;g„ IOP Commlaabn • IF 071680 Commini • FF 071NO
R. ho*wituaii r II
rlAsm.r
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
GI