HomeMy WebLinkAboutBuilding Permit Application 7728710863 p.3
Miranda Plumbing&KC
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
MECEIVED
Building Permit Application
Planning and Development Servines JUL 2 2015
Building and Code Regulation Division
2300 Virginia Avenue,Port Pierce Ft 34982
Phone:(772)462-1553 Fax-.(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click here
Address:1-0--�11)() a±aEl � R
Legal Description: A )a�
site Plan Name: Block No.
Project Name:
Setbacks Front Back:_Right Side: Left Slde:
DETAILED-DESCRIPTION OF WORKt
CON RUCTION"IN FORMATION:
Addition��Irktobanerformed under this permit—check all a ply:
11 Electric 7 Plumbing F 1prinklers nGenerator Roof
Total Sq, Ft of Constru ction- SQ. Ft.of First Floor.
-__ eptic Building Height:
cost of Construction:-S to,ndl� Utilities.,F]Sewer r7 S
OWNER/L-ESSEE: CONTRACTOR:
Address: Companyk
Fill in fee simple Title Holder on next page If different E-Maihn
from the Owner listed above) State or County License:c.
If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
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Miranda Plumbing&AC 7728710883 p.4
DESIGN ER/ENGI NEERJ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name:Address., Address;City: State: City: State:Zip: Phohe: Zip: Phone:FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: NotApplicable Na me: Name:Address: Address:City: City:OWNER/CONTRACTdR AFFIDVIT:Application is hereby made to obtain a permit to 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 it holder to build the subject structure[th an�epresentatlon thatis granting a permit will authorize the perm which is In Conflict w applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult w1th your Home 0-Amers Association and review your deed for any restrictions which may apply.In consideration of the grantTng of this requested permit,I do hereby agree that I will,In all respects,perform the work In accordance with the appToved plans,the Florida Building Codes and St.Lucie County Amendments,The following building perrpit applications are exempt from undergoing a f ull concurrency review:room additions,accessory structures,swimr ing pools,fences,wells,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 you?-property, A Notice of Commencement must be recorded and posted on the jobsite before-the first inspection. If you intend to obtain financinig, consult with lender or an attorney before Sign�ature of Owner/AgenV Lessee -�ign—atTire-ciec-qntractor/License Holder The for Ing instr s acknowledgeLdo bpelore me The ristrument was acknowledged before me $;--k pe"fl,day of 20LI:I-by of -J-oh t hI thiVrf61Ci 20Miy(Name of person acknowle dgin c; (Name of person acknowledging) ma(tignature of Notary Pubii Staie'of Florida M-1 9 (Signature of Notary Putfic-Siate'of Florida I Personally Known OR Produced Identification cx Personally Known OR Produced Identification Type of Identification Pro uced Type of Identification Produced Commission (See!) Commission No. af—V63 (seao Revised 07115/2014 REVIEWS FRON1 ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE� COUNT:R REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED