HomeMy WebLinkAboutBuilding Permit Application Date: ` 1 J Permit Number:
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Building Permit Application RECEIV
Planning and Development Services JUN ' 6
Building and Code Regulation Divlslon 20-
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462.1553 Fax:(772)462-1578 Commercial^_ Residential
PERMIT APPLICATION FOR: Mechanical �t
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Legal Description:, ,�r 'ri�� (S ICO Fit I-, I -5A//) F;--�Fe�5 (, 44t Ne Yrf
Property Tax ID#•_,�yc�c A [/ms LZQ A/ Lox No,
Site Plan Name: Block No.
Project Name: 3;�ine,S
Setbacks Front Back: Right Side: Left Side:
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ACclitional wor oe e orme un er is permit Check a _ appy:
FST
HVAC EIGasTank []Gas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:
SC Ft.of First Floor:
Cost of Construction:$ 5796— 00 utilities: Sewer[]Septic Building Height:
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»lame /Y ;AA1& Na S i'?rr7
Address:" C pan#'
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City: _Li!2_ ,.` tate: / A Egg: � r�/C1'f ?�T:X
Zip Code: Ci
'•"oPhone Zid' k
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-Mail: Phone No..:7? Cl/o / 7//
Fill in fee simple Title Holder on next page(if different E-Mail: S GCO/ cO
from the Owner listed above) State or County License:
if value of construction is$2500 or more,a R9CORDED Notice of Commencement is required.
8 A # ZZLgGgtZLL-' 8L9LZ9ti:01 :Woad, 90:W96-96-90
06-16-15;04;06 ;From: To:4621578 ;7724618722 # 2/ 8
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Ot Applicable
Name: Name:
Address; Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: 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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or andcovenantsthat 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 jobslte
before the first inspection. if you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
01
. s
Si ature of owner/Lessee/Agent Si ature of Contractor/License Bolder
STATE OF FLORIDA `` STATE OF FLORIDA
COUN'T'Y OF JG C/e COUNTY OF.
The for Ging instrume t was acknowledged b fore me The forgoing lnstrum t was acknowledged before me
this�,day of A-� 20/,5—by this J&day of 20 Lr by
Jame-5 J �
(Name of person acknowledging) (Name of person acknowledging)
(&Jo a4 La= 1:�0-V. Iz,5-1/wa-4,0 C
(Signa re of Notary Public.State of Florida) (Signatur of Notary Public-State of Florida)
Personally Known ...COR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 5A IOiNwMN Commission N SANDRA 1404ANN
,. .
r'4°r
Notary PubIIC•S{iN W F10�� �+Q~� X10- Notary Public-Stale o1 Florida
.•a y omm. rip r _ • ;ray GUM,DWI mar 14.Z014
Revised 07/15/ (�N; �� Commission 0 FF 07141!0 f�ayS «�� �° Commission*FF 071680
armed Th(wo NIItWoM Asse �,,,,��,• BMW'itr O Naloaal Ndary Ann.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
IAIITIAI S