HomeMy WebLinkAboutBuilding Permit Application date: I566—0 45
Permit Number:
0 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
PERMIT APPLICATION FOR: Mechanical xe,
1101"A 01"O'Stli"12"IM MAMINji"Ot-rA I
Address: 4bqD
Legal Description:—L-I&
Property Tax[D#: ?2q 0 Lot No.
Site Plan Name: M 6 b X L Block No.
Project Name: 80b:0
Setbacks Front Back: Right Side: Left Side:
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A00itional worl(Tobe performed uncler apply:
r7M is Gas Piping Shutters
HVAC GasTankD"'t ing — Windows/Doors
11Electric El Plumbing E]Sprinklers 11Generator Roof
Total Sq.Ft of Construction: S Ft Of First Floor:
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Cost of Construction:$ Utilities't SewerE]Septic Building Height,
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E-Mail: Phone No. 7 9e;)L
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Fill in fee simple Title Holder on next page(if different E-Mail: I-)b
from the Owner listed above) State or County Licen?e- 1AD 71
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: �2 Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: of Applicable
Name: Name:
Address: Address:
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 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 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 Commencement.
s
4siture of Owner/Lessee/Agent nature of Contractor/Ucense Holder.
STATE OF,FLORIDA L �� STATE OF FLORID
COUNTYOF •_ COUNTY OF'
The forgoing Instrum,nt was acknowledged before me The forgog Instrument was acknowledged before me
this day of G' 20/,V_by this�t ay of-�,_/L�- � ,20 t5._by
(Name of person acknowledging) (Name of person acknowledging)
4- WO_A'�'
(Sig ture of Notary Public State of Florida) (Signature of Notary Public-State of Florida)
Personally Known L--�OR Produced Identification Personally Known AOR Produced Identification,
Type of Identification Produced Type of Identificat )n-Produced
1111N e-
Commission No. hw S HOHMAHN �' Commission Na. _-"�'""' SaN:.i{Se�l)Mgpgr.
Notary Pub Comm.Eitplreii Ms
ilC-Stare of Florida U: . :•=My Cpm F JIx 5tit+gl
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Commission,#FF 071000gam,.:; 'sem�
Revised.07/>5/ z F;;;;;,: ` gaaea Throu9n Haliotnl f y ► MMIQw Aon
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS •