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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION•- i ALL APPLICABLE INFO UST E COI�11 PLETED FOR APPLICATION TO BE ACCEPTED / / Date: 1 SCANNED Permit Number: 1 S 01 4 BY St. Lucie County Building Permit Application I Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 l- Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: Mechanical Address: 1.0 LQQQ � C-P,Qt� �©�v' I /��, Legal Description:--00-jearl Gi: 'ESQUA' -QrNd ©rn i n i U un ff L 1 n i 'c- 02 Property Tax ID #: L 5i l5i '7 - 005.5 — C7C:CJ - Lot No. Site Plan Name: Block No. Project Name -�I17) 1���vnrZ Setbacks Front Back: Right Side: Left Side: CONSTRUCTIONN: , INFORMATIO.. Haamonai wo IK to De errormeo under this permit- check all app y: ZHVAC Gas Tank ❑Gas Piping Shutters 11 Electric 0 Plumbing ❑ _Sprinklers Generator Total Sq. Ft of Construction: I ©,7;? 3 Cost of Construction: $ 3;t C>U • CO i 5 . Ft. of First Floor: _ Utilities:[]Sewer Septic Windows/Doors Roof Building Height: 0lu 11VNER/.LESSE,Ea ` CONTRACTOR Name Name: DOUGLAS PENCE Address: _- t om m(. , Og-e-S Company: ABSOLUTELY COOL AIR CONDITIONING City: iel� State:flr0A Address: 2311 NE 15TH COURT Zip Code: ZN L "7 CiY4 Fax: City: JENSEN BEACH State: FL Phone No. A-75e 4041 Zip Code: 34957 Fax: E-Mail: Phone No. 772475-4641 Fill in fee simple Title Holder on next page (if different E-Mail: absolutelycoolair@gmail.com from the Owner listed above) State or County License: CAC1815702 •.-....... ar. raroav �uwn �a paovv vl uwl a, o nc%.vnuCu moucc or uummencement is requires. � I I 5i1PPLEMENT4l CONSTkUCTi010 N Lii+N tAW_iNPaRMAt' DESIGNER/,ENGINEER: _ Not Applicable MORTGAGE COMPANYApplicable : Not A ppllcable Name: Name: Address: Address: City: i State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Applicable Name: _Not Name: Address: Address: City: City: Zip: Phone: I Zip: Phone: , UWNtN/ GUNTRAC.TUR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that n�o work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permitwill 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 Horne 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 i r paying twice for improvements to your pr Notice of Commencement must be recorded d po d on the jobsite before the first ins a n. If o intend to obtain financing, consul th lender/or an at rney before commey,dnIi word or ecordi y your Notice of Commencement. nature 9F)Ywnei/ Agent/ Lessee re of0antractor STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ---�-T Ii't A— COUNTY OF i The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this i day of 20� by this Cam` day of ;t� , 20[ 7f by as - (Name of perWh acknowledging) (Name of pembn acknowledging) (Signature of Notary Public- State of Florida } Personally Know n I/ OR Produced Identification Type of Identification Produced Commission No,l (DEBORAH RUSSELL Notary Public - State o3Florida F:Xnirps Nov Commission # FF 179630 Revised 07/15/20 ,OF F 1o¢�, Bonded through National Notary Assn. (Signature of Notary lPublic- State of Florida } Personally Known " OR Produced Identification Type of identification Produced ission No. I ORAH RUSSELL Notary Public • State of Florida es Nov 30, 2018 Commission # FF 179630 Bonded through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED _ a�