HomeMy WebLinkAboutBuilding Permit Application Miranda Plumbing&AC, 7728710863 p.2
ALL APPLICABLE INFO ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: v
QJ I' ] 1, -
Permit Number.
Building Permit Application
Piannfng and Development Services
Building and Code Regulation Divisioli
2300 Virginia Avenue,Port Pierce FL 34982
Phone:(772)462-1553 Fax:(7,72)462-1578 commercial Residential 1'1�
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSED INPROVEMENT LOCATION:`
Address: 1641 D S .. Ckffin Nr'islf.
Legal Description: h I CI ub P'�Qir+CIHI
PropertyTaxlD#:LA,t?11-510-,COBEt:C(M -a Lot No.
Site Plan Name; Block No.
Project Name:
Setbacks Front Back!_Right Side;' Left Side:
DETAILED DESCRIPTION OF WORK:
Vk
lap'
CONSTRUCTION-INFORMATION:
AdditlonalveTktob"artormed under this permit-checK all tliat apply-
i0Gas Tank
VAC I DGas Piping _Shutters Windows/Doors
Electric 7—Plumbing F7Sprinklers [:]Generator Roof
Total Sq.Ft of Construct!Qn: SCI.Ft.of First Floor:
Cost of construction.,$ Utilities:[:Sewer�Septic Building Height.,
OWNER/fESSEE: CONTRACTOR:
Address Company ffcvf1
State:L X_% A d d rP4 s
Zip Code: Fax: C it State:
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Phone No`._�_V_��Lt Zip Code:'�;?LACR D' Fax-.1"IM-4 AS3
E-:Mall: Phone NO. I
Fill in fee simpleTitle Holder on next page If different E-Mail:n L _%,CXa]
2�t fnDdqL0
ACI�715'
from the Owner listed above) State or County License:
ltvalue o of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
Miranda Plumbing&AC 77287101863 p.3
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,L: IVIS JTALFC NS7'R°UC."Tl(?N'L EN'LA1A1='N 0 `MM.,O !':
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Nbt Applicable
Name: Name:
'Address: Address:
City: �� State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HO L ER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:
r Address:
City: City,
Zip: Pho e: Zip: Phone:
OWNER/CONTRACTC R AFFIDVIT:Application Is hereby made to obtain a permitto do the work and installation as indicated.
i certify that no work or in tallation has commenced prior to the issuance of a permit,
St.Lucie CountY makes no epresentation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable dome 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 thea ill ting of this requested permit,I do hereby agree that I will,In all respects,perform the work
in accordance with the ap�roved 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,swi7..
ing pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TC - NEYour 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#e first inspection. If you intend to obtain financing,consult with lender or an attorney before
commenhing work or 6ecorcling your(Notice of Comm enceme
sigriature of Owner/Ageril Lessee Signa re-dontractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF COUNTY OF
The fo ng instrument 4 s acknowledged ore me..+� ,No The forging instru ent was acknowledged before me .`�� '"4 ,
this May of I� ,2o�by ;?n this 'flay ofI��_C\ — 20 1 ti
�qnn+
(Name f person acknowl dging) rn a (Name of person acknowledging) m
o � Q='wady
Signature of Notary Publi-.-State of Florida) .�$05- ( ignature of Notary Public-State of Florida i A KPI
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Personally Known OR Produced Identification Personally Known OR Produced identification
Type of Identification Produced Type of Identification Produced
Commission No.C i is (Seal) Commission Notkj _0--_,�4�" (Seal)
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Revised 07115/2014
REVIEWS FRONI ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUN R REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE l
COMPLETED }
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