HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -t
Dater 1 1 Permit Number.
JUL 01
Bluilding Permit Application
Planning and Development Services.
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone-.'(772)46271553 Fax:(772")462-1578. Commercial Residential V-1
PERMIT APPLICATION FOR:. Mechanical
PROPOSED INPROVEMENT LOCATION:
Address:
Legal:Description:
Property Tax I D#: 1,50\- UQ U- (20-2-- C_XDQ'` 2 Lot No. 21::�7 .
Site Plan Name:" 1^r t Block No.1,.
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
NC:A. No ur
CONSTRUCTIONINFORiVIATION:
-Additiona wor .to a Orme under this permit-check a a appy:
HVAC Gas Tank aGas Piping Shutters Q Windows/Doors
Electric Plumbing FSprinklers Generator Roof
Total Sq. Ft of Construction: S •Ft.of First Floor:
Cost of Construction:$ Utilities:]Sewer Ej
Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Nam Name: JOHN BROWNING
Address: Company: JB"S AC&ELECTRIC
City: State:FL Address: 1535 NW QUAIL CIR
Zip Code: Fax: City: STUART. State:FL
Phone No: Zip Code: 34994 Fax: --�
E-Mail: Phone No.,772-934-6778
Fill in fee simple Title Holder on next page(if different E-Mail: lbrowningac@gmail.com.
from the Owner listed above) State or County License: CAC1816319
if Value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
S�IPPLEt1itENTA�CO�USTRl1C`fl®!� LIED �A�11I�IN��RMAT1®N�';DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: - Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE S-IMPLE TITLE FIOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: Clty.
Zip Phone: Zip:. Phone:
OWNER/CONTRACTOR.AFFiDVIT:Application is hereby made to obtain a.permit to do the work and installation as indicated:
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 anyapplicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such..
structure.,Please.corisult with-your Home Owners.Association and review your deed for any'restrictions which may.apply.
In consideration of the granting of thfs.requested permit,I-do hereby;agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codesand St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrencyreview:room additions,
accessory structures,swimming pools,fences,walls,'signs,screen rooms and accessory uses to another non:residential use
WARNING TO OWNER:.You r,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
commepcin work or recordingour Notice of•Commencementr,)..;
.if
Signature of oWnea4gentl Lessee Signature of Contr�gct,cen Holder
STATE OF FLORIDA �-ATE OF FLORIDA
'COUNTY OF T( , COUNTY OF
The f1 Egging instrument was:acknowledged-beforeme The Ing instrument was acknowledged before me
thisday of 20 by this day of 201 by
, nl.l
(Name of person acknowledging).,.' (Name of personack.nowledging)
?
(Signature of-Notary Public-State:of Florida) (Sig'na'ture of Notary.Public'.State.of Florida} ,
Personally Known OR Produced Identification Personally"Known: ✓ OR Produced Identification
Type of Identification Produced Type of.Identification Produced
DEBORAH RUSSELL
Cornmission.No. s�"�s Commission No. "".=DE
`-
.Notar �c-State-of Florida ,�
'EE
`,o�PaY n�e( DEBORAH USSELL
]My Comm.Expires Nov 30,2018 Notary Public-State of Fl179630 . , �.Bonded through National Notary Assn. * My Comm.Expires ov , io
Revised 07/T5/20 :;. �o` commission#,FF 1796°;;°�� 'Bonded through National Notary
REVIEWS FRONT ZONING SUPERVISOR. PLANS VEGETATION SEA-TURTLE MANGROVE
COUNTER REVIEW REVIEW' REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
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