HomeMy WebLinkAboutBuilding Permit Application From:Advance AC LLC Fax:(877)6549684 To: Fax: +1(772)462-1578 Page 2 of 14 05118=1 5 5:50 PM
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 15RECE���`IU Y 19 'it Number: 5 O S.- Oar,a
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 I.,"
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Legal Description: �:. w .- ,,�,s..�"'., '�r' ,y�l,,�'�. ,� -:�€-•' `� �,..�', .�� � < ,
Property Tax ID# s Let Na.
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Site Plan Name: Block No.
Project Name: ' �i1S —
Setbacks Front Back:. Right Side: Left Side:
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e ition -wor o e er arme un erTis perm Et-c ec a I I app y:
HVAC Gas Tank Gas Piping ShuttersnWind
aws/Doors
Electric Q Plumbing Sprinklers Generator Roof
Total Sq,ft of Construction Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: 0Sewer L 1Septic Building Height:
4WNtR� 141w7.77777
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Name 's _ Name:
Address \tom, j�c "'a 1 s _ ;
-,� �" � "�� Company
City: k State;'1�f� Address (i
Zip Code i E Fax: City: State
� -%3c,(,, f--� ( LPhone No.°41-1Zip Fax
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E-Mail: Phone No M r t
Fill in fee simple Title Holder on next page(if different E-Mail: ,k-
( from the Owner fisted above) I State or County License v f f i :,t
tf vaEue of construction is$2500 or more,a RECORDED Notice of Commencement is required,
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From:Advance AC LLC Fax:(877)654-9684 To: Fax: +1(772)462-1578 Page 3 of 14 05118!2015 5:50 PM
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lyrrTrcity:
MORTGAGE COMPANY: Not Applicable
Name:Address:
: State:
Zip: Phone: Zip: Phone, _
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name: . _
Address: Address: j
City: City:
Zip: _- Phone: Zip: Phone;
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County snakes 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 your Notice of Commencem t,
Signature o Contractor License Holder l
' - attire ssf O erJ Lessee/Agent g ;
STATE OF FLORID4 it STATE OF FLORIDA:. �
COUNTY of ,•,.. I COUNTY OF
The f r Ding instrument was acknowledged before me The forgoing instrument was acknowledged before me j
this
day '6::° 20Y this�v day of Ff +a c __ 201,_ by
t
Name of person a tf ' W. s i ,i ! ame of JORGE MAROULZ
ersar�acknawted in )
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i Signat of
Notak Public-Stere—of Florida) l i natur ary PutMtc Stag f•El rlc .�. Y '„ f'!
{ Personally Known OR Producedidentification _ Personally Known OR Produced identification
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Type of identification Produced f. ,- Type of identification Produced EiC.. d ,
Commission No._ tft (Seat) Commission No 1L` f �' � :�� (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION � SEA TURTLE I MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW � REVIEW
GATE
COMPLETE
INITIALS