HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONt_
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: a` i N Permit Number: I �yd' 00 Y
SCANNED
Building Permit Application BY
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _ Residential
PERMIT APPLICATION FOR: Mechanical
Address:
Legal Description:iTA(ALA9rizlo.9 Sib LOT 7L,s5 S Qp r•}-
Property Tax ID #:�,�Y �J�o� b�C»J (� Lot No.
Site Plan Name: 1J Q() !l ni M �/3� !� ��� Block No.
Project Name: D f�1 AFr l 1 o 1 0%Y0 yw .
Setbacks Front Back: Right Side: Left Side:
ill }oeak�Vn CI) Cp.I S}�C\C!� (
bc\-to \-� k-w
510
ZHVAC UGas Tank
11 Electric El Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ & I to & I —
Piping
H/(L- '3k-f
.,. f
apply:
Shutters ❑ Windows/Doors
Generator Roof
S Ft. of First Floor: _
Utilities:n Sewer []Septic
Building Height:
ClWNER(LESSEE t "-
,CONTRACTOR:,'
Name-0 candw L hk LLC
Name:
cI� 1
Address: 0-7 54 Ptf\Q 1 1 i 1915 ��
Company: GRIMES HEATING AND AIR SQL
City:,�UQ�OtI State: FL
Zip Code: *3 33 3Fax:
Phone No.
Address: 3054 N US HWY 1
City: FORT PIERCE State: FL
Zip Code: 34946 Fax: 772-461-8722
Phone No. 772461-8711
E-Mail: t 1un(legI F3 a/%1
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: shannag(mesac@aol.com
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONS,TRUCTIQNLIEN LAW INFQftMAT10(U
`' '•s ��g `"'
DESIGNER/ENGINEER: = Not Applicable
Name: 1OP—Or7T S\(-6 a
MORTGAGE COMPANY:
Name:
Not Applicable
Address:® S —1 "` Sk•
Address:
City: IV State:
Zip: gA)__z7 LIgfio Phone* -11 Z W1 Z 4 (¢3"1
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY:
Name:
x Not Applicable
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
beforkt Tip first inspection_ f you intend to obtain financin on ult with lendeyor)an attorney before
comrhendine work orTeine vour Notice of Commenc ent � J
of Owner/ Aeent/ Lessee
STATE OF FLORIDA
COUNTY OF
The for oing instru ent was acknowledged before me
this ydayof� 20_16by
JapleS
(Name of person acknowledging )
oL /GL�W�W���`-'/
(ture of Notary Public- State of Florida
)
7Ponally Known OR Produced Identification
Type of Identification Produce4.AAdh.,66mb&mdbd6,dhaw
Commission No.
Revised 07/15/2014
re of
STATE OF FLORI!yZ
COUNTY OF ��
Holder
The for oing instrum'e7t was acknowledged before me
this day oof,�)�� 20�y
ia' &`J 4 jnw?_e5
(Name of person acknowledging
(Sign re of Notary Public -State of Florida )
Personally Known r� OR Produced Identification
Syuhp�mf Identification Produces m _ _ _
SANDRA HOMMAM
albUry Public - State o1 IOk08 fission No.
My Comm. Expires Mat 1 _ 201 I
sANDRA HOHMANN
SNelay Public - State of Ft
My Comm. Explfes Mar14.
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