HomeMy WebLinkAboutBuilding Permit Application Miranda Plumbing&AC 7728710863 p.2
�c mo
ALLAPPLICABLE BE COMPLETED FOR APPLICATION TO BE
Date: WW' 7ACCEPTED
1MUST 5� Permit Number:. L)
Wi •
Building Permit Application RECEIVED
Planning and Development Services
Building rind Code Regulation Division JUN 19 2015
2300 Virginia Avenue,Fort Pierce FL 24982
Phore:(772)462-1553 Fax: (772)462-1578 Commercial z_1--"— Residential
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSED IN PROVE M ENTLOCATION f.
Address:Q , I-Acocl
Legal Descriptlonoi on r4- c,�P Eec -L\)o kb c
ond- coriTic, 44N, G
Property Tax ID#.q=- 113- cool-0107( o Lot No.
Site Plan Name., Block No.
Project Name',
Setbacks Front_ Back, Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
5 Ku) U see,(— C
VeD VV&kl
CONSTRUCTION INFORMATION'
Actona r to e erformed under this permit—check all ttlat apply'.
VAC Gas Tank Das Piping FIShutters Windows/Doors
DElectric 0 Plumbing OSprinkiers In Generator Roof
Total Sq.Ft of Construction: So. Ft.of First Floor:
Cost of Construction:$40� Utilities-. OSewer 7 Septic Building Height:
OWNER/LESSEE: ff CONTRACTOR:
Name
Addre L L(�O, Company: *if-eN�n(,kcLvcu:, 41&i
City: cr, State P Addr sr
1:�*�W�
Zip Codax: Cityor� Lv-
State:
M -
Phone N Zip Code..qL- FS, Fax _3
E-Mail:
Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License,.C. lJ
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Miranda Plumbing&AC 7728710863 p.3
i
SUPPLEfVtENTALC NS?ESU.CTIQN'( ENat%1N:"tN•FR'lV1AeT40N�
asp :•
DESIGNER/ENGINEER __ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: I Name:
'Address: Address:
City: f State: City: State:
Zip: Pho e: Zip: Phone:
FEE SIMPLE TITLE HO L ER: _ Not Appilcable BONDING COMPANY: NotApplicable
Name: Name:
Address: Address:
City: I City:
Zip: Pho e: Zip: Phone:
S
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 litallation 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 gran,ting 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 perr4 kt 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 0 NE FF��:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to.youproperty.A Notice of Commencement must be recorded and posted on the lobsite
before first inspection. If you intend to obtain financing, consult`with lender or an attorney before
commenWng work or eecording vour Notice of Commenceme
t
Signature of Owner/Ageni Lessee Signa ee..o`tpritractor/License Holder
STATE OF FLORIDA STATE OF FLO 1 A .. t
COUNTY OF �' �� COUNTY OF �� C i'E' Cf►1J5 t'<C
The or ing instrument was acknowlecied before me.404! 4-r The f ng in ment was acknowledged before me
this of NJQ_.r 2dualiy ��a this'��Sy o�\)M 20 by
,�yp.� +I Ilnta
(Name of person acknowledging) o (Name of person acknowledging I c��v
(Signature of Notary Public-State of Florida) a ('Signature of Nota Publlc-State of Florida) Il An
en ex �
Personally KnownOR Produced identification Personally Kno OR Produced Identification
Type of Identification Produced Type of Identification----Produced
�
Commission No. Sr(Seat) Commission NoE��� 5 (Seal)
Revised 07/15/.2014
REVIEWS FRONI ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNT R REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
t
1
i =-