HomeMy WebLinkAboutBuilding Permit ApplicationApr 1915 09:49p Advantage Air Cond.
3213124575 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: L\ lao � k 5 . . Permit Number:
Yy
RECE-1V"W, A?R,2 0 N5
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential —7\
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: -G C? H S I Ver- � k -
Legal Description: Z:Qar) P,\'yer7 ljjq't0/,7 - BLK, 1,T U4, -;2:3.
Ci.
Property Tax iD #: - L'(
Site Plan Name: vl--ejer--1
Project Name: Fred e Y' I L K
Setbacks Front_ Back:
1,;2,,S4/ —
Right Side: Left Side:
Lot No..Z3
Block No. f3
DETAILED DESCRIPTION OF WORK:
�o C(�v-qe 04t -f — Ito 5eer, 3 -fin 41C 1,cvi'I-L
ka --Gr
CONSTRUCTION INFORMATION:
AaujiionaiWOUKLOL)t!Pt:!IIUIITIUU
NHVAC
OGas Tank
WILIMI
Lill:?
0Gas
JJt:111l1L— 611=61%, -all
Piping
Mapply-
Shutters
E]Windows/Doors
Company:
City: j::jle rC C State:
A 11(ht-at
Address: / Xe J
. ..
. ...
Zip Code: -3467,q.?- Fax:
City: &bw
State: ref
0
Electric 1:1 Plumbing
Fax: 3-24 �3loZ S'7
OSprinklers
Phone No.
Fill in fee simple Title Holder on next page (if different
Generator
(X- (91-'-) _C6.,r)-N
F]Roof
State or County License:
Total Sq, Ft of Construction:_ 70 0
-
Cost of Construction: $ c ';2X)Q00
SO. Ft. of First Floor: —
Utilities Sewer 0 Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name �re,cerick da -t --nn
Name: AAwayl4a. r W
-r- c-4 • l`'...
Address: 511 r Iver 6-dk -De_
Company:
City: j::jle rC C State:
A 11(ht-at
Address: / Xe J
. ..
. ...
Zip Code: -3467,q.?- Fax:
City: &bw
State: ref
Phone NoQla cZ214 - &,2 (e-3
Zip Code: 3� 0 0�7
Fax: 3-24 �3loZ S'7
E -Mail:
Phone No.
Fill in fee simple Title Holder on next page (if different
E-Mail:01 P'J 410 MZ2 Y1 6
Z
(X- (91-'-) _C6.,r)-N
from the owner listed above)
State or County License:
or MM5-5-Vp
If value of construction is 57-500 or more, a RECORDED Notice or Lommencemenr is requires.
Apr 1915 09:50p Advantage Air Cond,
3213124575 p.3
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address: 1 Or
City: =State:
city: State.-
—
Zip- Phone: — I- '
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work orinstallation 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 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
'/_- At- ( z V L/_ s
Signature of Ow-'ner/ Less4-/Agent Signature of Contractor/License Holder
STATE OF FLORIDA -72 STATE OF FIA
IWA-
COUNTYOFr-C Vezc cl) COUNTY OF 4nrC L(n
The forgoing instrument was acknowledged before me The forgoing instrent was acknowledged before me
this I I 12=9 day of r- 1 20 1_�by this, U day of IrYl 20 � by
(Name of person acknowledging) {Nameofperson acknow—ledging)
Ocy
(Signature of Notary Public- Stat 6 of Florida) (Signature of Nota Public- State 6f Florida)
Personally Known ORIcation Personally Known OR Prod_Qced Ide tiffication
(&-, Type of Identification Produced,
Type of identification Produced
Commission No. ."S' Commission No.
F' Expires: SEP 16, 2018
I or FLOR10A NOTARY, LLr
Revised 0711512014
Me*ix
#FF160568
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