HomeMy WebLinkAboutBuilding Permit Application .
Miranda Plumbing&AC 7728710863 p 2
ALL APPLICABLE IN MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; (4 A Permit Number-�� coo5
Building Permit Application
Planning and Development Services
Building and Code Reg ulotion DIvislon
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Se!ect from drop box, click here
PROPOSED INPROVEMENT'LOCAT- rON:
Address- n' 9VT-1-
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Legal Descriptloni lr(�—vj -"n-+MJ
PropertyTaxlD#: -?�SL7E—(Q0-S,— ' --(M- 40 Lot No )(0
Site Plan Name: Block No.
Project Name:
Setbacks Front— &2ck.,_Right Side-._Left Side;
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f-TAILED DESCRIPTION OF WORK:
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KT L&)
LOCOA3 e1r) 1 1CIA
CONSTRUCTION INFORMATION:
AdditlonaWorKtOneoartormecl under this permit-c ec all that apply,
LXC Gas Tank OGas Piping _Shutters VA Windows/Doors
DElectric Plumbing []Sprinklers 0 Generator Roof
Total Sq.Ft of Construction- So. Ft.of First Floor:
cz-- 4q q
Cost of construction:$�.)-
Utilities-[]Sewer Z Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
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Name Namek,
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Company: ','r6V(vkLV).Vi °`t •
City: State:•:, - Addrgs V"W enle
Zip Code q LN Fax: City:Vbr+Q-) ori'p- State:
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Phone A2� 12 —uu- R Fax U
N Zip Code qC4 q V
E-Wiall.Y)MC Mciffidya k, rino R'(Cnli�W%Afro—::9�� 3'2
Fill in fee simple Title Holder on next page(if different E-Mail:m LM aLpEAca f(a
from the Owner listed above) State or County License
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if value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
Miranda Plumbing&AC 7728710863 p•3
SUPPLEI4'I �..TAL`C NST UCTIO:N;-....
EN: l r_ !EN;; 1N l N F G R['JIATiQ,IV - .F.,
DESIGNER/ENGINEER ,_Not Applicable MORTGAGE COMPANY: Not Applicable
Name: i Name:
'Address: Address:
City: I State, City: State:
Zip' Aho e•. Zip: Phone:
FEE SIMPLE TITLE}i0 ER: ____Nat Applicable BONDING COMPANY: —Not Applicable
Name: Name:
Address- Address:
City: City:
Zip: Phone: Zip: Phone:
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OWNER/CONTRACTO, AFFIDVIT:Application is hereby made to obtain a permit to do the work and Installation as indicated.
i certify that no work or in allation has commenced prior to the Issuance of a permit,
St.Lucie County makes no epresentation that is granting a permit will authorize thepermit holder to build the subject structure
which is In conflict with an applicable Home Owners Associatlon rules,bylaws grand covenants that may restrictor prohibit such
structure,Please consult th 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 per'it applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swim ing pools,fences,walls,signs,screen rooms and accessory uses to anothernon-residential use
WARNING TO OWNS :Your failure to Record a Notice of Commencement may result In your paying twice for
improvements to youi property. A Notice of Commencement must be recorded and posted on the jobsite
before
a first inspection.If you intend to obtain financing,consult with lender or an attorney before
comrnenWng work or decordinizvour Notice of Comm cement----,
Signature of Owner/Agent/Lessee Signa antractor/License Holder
STATE OF FLOR ? STATE OF FLORI �
COUNTY OF - 1 COUNTY OF
The f �g inst ment ;ss acknowledged before me�,��" :'��'.. The rging Instru ent ways acknowledged before me 41W.
this y of ; ,20 by ?�' t`y this ay of_j 20�by S ":a
+y yyyU,
w-�^�.. -+iI* fie•' ^ ,,+�;Wrl
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=-ipersoning) m S a (Name of ersonacknowledging) VA
Qirewo�i
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(Si ture of Notary PubliE-Sta of Florida) o$o ( ignature of Notary Public-State of Florida) as
tts ens 8, l
Personally Known OR Produced identification Personally Known Ooduced Identification
Type of Identification Proc uced !- Type of Identification .cation Produced
Commission No. — ! 0'-9 (Seal) Commission No,X- ? '5 (Seai)
Revised 07/15/2014
REVIEWS FRON ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTIR. REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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