HomeMy WebLinkAboutBuilding Permit Application 04/28/2015 10:29 7724621578 ST LUCIE CO IMPACT PAGE 02/03
Apr 28 15 09,38a Grossmann Air Conditionin 772-3989727 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLIGATfONTO BE ACCEPTED
Date: QA 5 , Permit Number:
s
Duiiding Permit Application
Planning and Development SEn Ices
Building and Code Regalotion ATvlslon
2300 YTginia Avenue,Fort Pierce F(34982
Phone:(77.2)$62.1553 Fax-(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select frorn dropbox, click arrow at the end of line
PROPOSED ii11PR7i►'iEi�f't"•�U '14a+ V .,.:..: .. _ .. ..
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Address: 114.75 plen 'if,
Legal Description: �lr
Properly Tax 10# -6D3 -0 Q Lot No.
Site Plan Name:—_ Black No.
Project Name-
Setbacks Front Back: Right Side. Left Side:
ol"'T,4141k1���s�'1pTlOM��ii�0��:-;;::: :°: �• °:- . . . .. ::: : :.;: .• ... •''• . .
PUP t&� r`tsid-len 01 - -Ouk ' ilk{i;V- (t'6,
5 Keo
NINIM
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l na Wor to j orme un er -is Rerm�.–C ec a apply;
HVAC �.,1Gas Tania ❑Gas P'•ping Shutters ❑Windows/Doors
❑Electric ❑,Plumbing ❑Sprinklers �Geniarntor ❑Roof
Total Sq.Ft VT ClUIral,ructlon: Ft.or first Floor:
Cost of construction:$' r? uc Utilities: Sewer 0 Septic Building Height:
OVIfKEk f--E;$EE:'
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Name Qr Name:
Address: Compani� i+
City: ' State:- ,r Address:
1117', 3 Sii - �.
Zip Code. �' Fax_ — CiN: .�' f S
ivo. �
Phone � _ Zip Cade: Fax.,
E-Mail: _ �v tffJ?f Phone No.
Fill In fe simple Title Halder on next page(if different E-mail:
from the Owneriisted above) State or County License: 1 ¢/
TF valuq of eonstr.,ction b 525CO er more,a RECOR090 Neto,rvf Commenrerncnt is regyired,
04/28/2015 10:29 7724621578 ST LUCIE CO IMPACT PAGE 03/03
Apr 28 15 09:35a Grossmann Air Conditonin 772-3989727 P2
0C
DIESIGNERfIEN1511NEER: Not Applicable MOKrGAQE COMPANY: Not Applicable
Name; Name:-- _
Address: Address:
cltv. State-,_ City: tote:
Zip. Phone-- Zip: Phone.—
FEE SIMPLE nTLE HOLDER: _Not Applicable BONDING COMPANY; Y Not Applicable
Name.— Name:
Address: Address:
city: City:-
Zip. Phone. Zip; Phone:
I ot'rt.'ry than no~4 ov;ntollation has commanr"-W prior to thct 1,-'%lAJncC Or D permit.
ST.Lucie. Coun%Makes no representation that is granting a permit will authorize the permit holder to build the subject structure
prohibit
which is in con, lCt.VAth any applicable cl
able HQe Owners _,soaticn rules,bylaws ce,indcovL,nantstmatrnrjyrcstrl,,t4orsuch
structure.Please consult with yoar Home Owners Association and review your deed for any restrictions which may aPPIY.
in consideratlort of the gra-itirg of this requested permit,I d i hereby agree that I will.in all respects,perform the work
In accordance with tho louraved plans,the Florida lluildinp dcs and 5t.LUCIC County Amendments,
The following building permit applications aro exempt from indergoing a full concurrency review:worn additions,
accessory structures,swimming pools,fences,watts,signs,screen roams and accessory uses to another non-rf 4dential use
WARNING TO OWNER:Your failure to Record a Not ce of Commencement may result in your paying twice for
improvements to your property.A Notice of Com-lericement must be recorded and posted on the jobsite
before the first inspection, torney bef6re
06you intend to obtain inancling,con.5vit with le 91er or n
commencin rdin our Notice of Co mencipment. -,.e--01-1 22,
ork or ir.�
Ix .,eve i
&Af 1,4A.
Signature toy/1-icts-me H*7
Signature
Sign of wMeTO�45_SwAgcnt je-'ff're'l I/evz"um"Zo. WA Ho
-,,'
I r _Ze eh�f
ST IDA ST RIDA
LOR ZF -C
C OF— IV C
F
The forgoing ins%-u ment was acknowledged before me 'The forgoing instrument was acknowledged before me
this 1A
day of Avrj 1 20A!�� ftaday of 20 by
(Name of persor ackrinwiedging;) (Name of person acknowledging)
'g
V$ij'n sibYie aAotary P ublfc-State of Florida l (5igr:ka of Mary Public-State of Florida
Personally Known OR Produced IderttlReation Personally Known OR Produced Identification
Type of identification Produced Type of Identification Produced
Corvnksfom No, oelelo commission No, 60,4_U Z25- �Seal
Mont) ail W. Gentle
NN. Gail H. Genfe
A
Revised 117111;/2014 ExPift'jo JAK 15,2DI3
Woe WAWAM, TAW=
REVIEWS FRONT ZONING 5UPERVISOR, PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE -
COMPLETE
INITIALS