HomeMy WebLinkAboutBuilding Permit Application Jul 0915U6:3Qa VVolfAhoon6itinning 7724641127 p]
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ALL APPLICABLE INFO BE COMPLETED FOR APPLICATION TO BE ACCEP'TED Date: —77 Permit-Numbei- 60 o WIN 14�1111111 Building Permit Application Planning and Development Services Building and Code Re4ulodan Division 2300 VirginidAvenue,FortPlerce FL 34982 Phone.(772)462-1553 Fax-(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrc>w at the end of line IMPROVEMENT LOCATION:Address: 1.; 11 Legal Description:Property Tax ID#3 1-fc,3 Lot No.Site Plan Name: Block No.Project Name:Setbacks Front Back- Right Side: Left SIde:DETAILED DESCRIPTION OF WORK: 'Additional work to be performed under this permit—check all that apply:OHVAC OGasTank Gas Piping U Shutters Windows/Doors[]Electric M Plumbing Sprinklers 0 Generator Roof Total Sq-Ft of Construction: Sq.Ft.of First Floor:Cost of Construction:$ Utilities:OSewer 0 Septic Building Height Phone No. ZipCode: Fax: '77.2 - IL/b f-1—Ild Fill in fee simple Title Holder on next page if different E-Mail:from the Owner listed above),, State or County License: 12 LIC 1213 aIf value of construction is t2500 or more,a RECORDED Notice of Lmmencement is required._
Jul 0615 06:39a Wolf Airconditioning 7724641127 p.2
SOPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENGINEER.- —Not Applicable MORTGAGE COMPANY. Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER* Not Applicable BONDING COMPANY: Not 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 the permitholder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws orand covenants that may.restrict or prohibit such
structure.Please consult with your Horne Owners Association and reviewyour 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:Yourfailure to Record a Notice of Commencement may result in yourpayingtwice for
improvements to your property-A Notice of Commencement mustbe recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recordin our Notice of Commencement.
5,– S
Sigegiviee-of Owner/Lessee/Agent jWpatu-r-616f Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF 12)-4
Theoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this IV day of. 20 Lt5�by this day of 20 �'Iby
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of NotaryPuglic-§iate of Florida)
Personally Known_OR Produced Identification Personally Known OR Produced Iderltification
Type of Identification Pro Identification Prod boa
M11 M14 MARTIN
Commission No. tyre -$taw*I sion No. Awt ISINOV Pit*-Stela of Hot I I
• Isidon 0 FF 21MI CortWaslon 0 FF 21695,
My Comm.IxMraz Apr 5,201 My Cmm.EVIres Apr 5.2
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Revised 07/15/2014
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