HomeMy WebLinkAboutBuilding Permit Application Miranda Plumbing&AC 7728710863 p.2
ALL APPILE17 sMUST-B"OMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ECE
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rmit Number.,
Building Permit Application
Planning and Development Services
Building and Code Regulotion Division
2300 Virginla Avenue,Fort Pierce PL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click,hee
PROPOStD'INPROVEIVIENTIOCAtION':
Address: iS La Vi I ELLA- L)'eav-2- 2),
Legal Description:
i 1501- Lot No.
PropertyTax]D#: I—
Site Plan Name. Block No.
—
Project Name:
Setbacks Front— Back: Right Side; Left Side:
DETAILED DESCRIPTION OF WORK:
seer
CON STRP.CUT-.ION-INFORMATION:
tion wor- to-be rforfin-ea U-nder this permit-checK all pal apply:
[I JGasTank�HVAC ElGas Piping UShutters Windows/Doors
UElectric [:Plumbing OSprinklers 1:1 Generator Roof
Total Sq.Ft of Construction: SO.Ft.of First]
irst Floor:
Cost Of construction.,$ 7-
Wn, Utilities:13 Sewer F]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name IONIC- r"Ne-CAIC10hrin Nam U)Cry--,T IfTA(A-
Address: -1-al i ll a_ Company: 1-(,YnA,6 Ivfn F_Q -�n
City: StateF Add s.7 W,
Zip Code i Fax: clty:M L�V,ip State
1_4q La Fax
PhoneNd L1 4- Zip Cocie,'c n7m4-
E
-Mall:fiMCA C.L �tQ'.C.ols'! Phone No=. 4
Fill in fee simple Title Holder on next page(if different E-Mail:l) t:ffl4iftK_\CO;
from the Owner listed above) State or County License:(L ACAQ5'A�LO
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Miranda Plumbing&AC 7728710863 p,3
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SUPPLEMENTAL C NSTRUGTION'.L IEN.-LAW INF0611'MATION
:
DESIGNER/ENGINEER.; Not App€icable MORTGAGE COMPANY: _ Not Applicable
Name: ' Name:
Address: Address:
City: State: City: State:
Zip: Pho 1e: Zip: Phone:
FEE SIMPLE TITLE HOI:DER: _ Not Applicable BONDING COMPANY: —NotApplicable
Name: I Name;
Address: I Address:
City: i City,
Zip: Phone; Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as Indicated.
I certifythat no work or installation has commenced prior to the issuance of'a permit.
5t.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 applraved plans,:he 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,wal!s,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
befor a first inspection. If you intend to obtain financing, consult with lender or an attorney before
commenNinR work or recording our Notice of Comm encemen
I
Sigtfature of Owner/Agent/Lessee Sign ath re�3f' ontractor/License Holder
STATE OF FLORLDA' �' f STATE OF FLO
COUNTY OF `�-1- � - COUNTY OF ����_��
rhe�o ng instr entwas acknowled eg d before me�.•� '.;;o,� The geng instr ent�y acknowledged before me
this' ay of ii 20 by this ay of 20dy ;c g
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[Nam f person acknow dging c (Name f person acknowledging}
{Signature of Notar Publi.b-State of F arida g o b (Slgnature of otary Public State of Florida)
Personally Known OR OR Produced Identification Personally Known L.—07—Produced Identification
Type of Identification,-Produced - Type of identification Produced
Commission No.E--l O�Q P`. --(seal) Commission No. r Q_:�� (Sea])
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Revised 07/15/2014 j
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