HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO OF ACCEPTED
Date: Permit Number:
r' III RECEIVED MAY 0 5.1. 0
Building Permit Application
Planning dnd Development Services
Building and Code Reguldtion W.visfon
230 Virgfola Avenue,Fort Pierce FL 34982
Phone:(772)467-1553 Fax:(772)452-1578 Commercial Residential x
PERMIT APPLICATION FOR: MoChanlaal
swim=
Address:
Legal Description:s '_'
Property Tax ID#; LOt No.
Site Plan Name, Block No.
Project Name:
setbacks Front--_- Back: Right Side: Left Side:
LIKE FOR LIKE AIC CHANGEOUT-NO DUCT WORK
or-W
ToVna un Wer ff Re CK all tlM pply: 19MMEOM
app
a
arm
_q L
wor to WtfGoWsTank Piping vee
a
0 AC Shutters Windows/Doors
DElectric Plumbing liSprinklers Generator Roof
Total Sq.Ft of Construction'. Sol Ft.of First Floor:
A * el'P15 I
Cost of Construction:$ Utilitiles'.0 SeWer Q Septic Building'Height:
MIMI: 1161,
Name CbLk) R%Xk Nome: JAMES DEGATINA
:
Address1_.tCk
(:ompany: ALL AMERICAN AIR&ELECTRIC,INC
City "S state:FL Address•. 611 NW MERCANTILE PL
tip Code., -I, Fox: City: PORT ST LUCIE State:FL
Phone No, Zip Code, 34986 Fax: 772-878-5144
E-Mail: Phone No. 772-878,5143
Fill in fee simple Title Holder on next page(if different F.Mall. KWOODCAAAF-INC.COM
from the Owner listed above) S14te or County License. CAC057965
If value of cansion Is$2500 or more,a RECORR6 N*tI;e of CommenceKent is required.
Fill
V
•DESIiGNER/ENGINEERc x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Ilk Name;
Address: , Address:
City: Stage:_- City. State:
Zip: Phone. Zip: ,_Ph e: . . "
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
city. city.
Zip: Phone: ZEp: _Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
5t.Lucie Count+makes no representation th4t is granting a germit will autporixe the(co2ainy
'mit holder to build the subject Structure
which is in conflict with an applicable Home Owners Assocration rples,by ay. or anvnants that may restrict or prohibit such
structure.Please consult with your Home Owners Ass&latlpn and review your deed restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that i wili,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments_
The following building permit applications are exempt from undergoing a full concurrency review;room additions,
accessory structures,swimming pools,fences,walls,signs,4creen roams and accessory uses to another non-residential use
WARNING TO OWNER;Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financin&consult With lender or an attorney before
commencing work or recording our Notice of Commeneement.
5ignat n$r/Age leasee
wrfractor/license Holder
STATE OF FLORIDA STAVE OF FLORIDA
COUNTY OFyrwoie COUNTY OF sTr_uctc
The f=oIng instrument was acknowledged before me The forgoing lnstt ant was acknowle ed before me
this day of 20 "by this day of 2by
JAMES OEGANNA JAMES oEGAIINA
(Name of person acknowledging) (Name of person acknowledging)
ignature of Notary Public-$tate of Florida) gnature of Notary pub ic-State of Florida)
Personally Known X OR Produced Identification Personally Known x _OR Produced Identification
Type of identification Produced Type of Identification Produced
Commission No. 8�10s CAIHOUN mmission No. EE 1015900 (Seal)
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Notary Pubiic-Stats of Florida
�.•,•°„{,,, GLA!t.GAI OUN
” rrosucr1Votary Pu Jc-FT
Slate o F o a
Commission sy 9E 105900 - * ,�•' My Cornm.Lfcplrss Oct 6,20i5
Revised afilI51ZO ''''%E;t. Banded Through National Notary Assts. ��kx �,= Conornisslan#EE 105900
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGE AT A U t. A , O lr
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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DATE
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