HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date- ((�� Permit Number:
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Building Permit Application
Planning and DevelopmentServices
Building and Code Regulation Division
2.300 Virginia Avenue,Fon Pierce FL 84982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Mechanical �, 14 L f
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Legal Description:_110 ,AA 1'N (.•_Q± 4 g
Property Tax ID#: _ a c - 0 000 to Lot No.�.
Site Plan Name: Wt) ktAci . , 4a(fin . Block No.
Project Name:
Setbacks Front Back: Right Side:_ Left Side:
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Orme un er ispermit-•c ec a appy:
VAC []Gas Piping _Shutters Windows/Doors
CElectric 0 Plumbing Sprinklers E2 Generator Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ ?ig� Utilities: Sewer Septic Building Height:
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Address: c c. s;�COT,Pan„ ;• r.rv�a;r; .`4 t cA T& re
�yn :��Cit, G� State: =Add'f �ti� c
Code: `��iuG1S 1 Fax: - 'Clty:
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Phone No., .,(�y Zip Code: `b t=ax: 77 41,E/ —'•t�7d
E-Mail: Phone No, 7')eA -L�LQ '~ Fr
Fitl in fee simple Title Holder on next page(if different E-Mail: 6117
from the owner listed above) State or County License: o�to
if value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
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07-05-15;21 :46 ;From: To:4621578 ;7724618722 # 2/ 6
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: of Applicable
Name: Name:
Address; Address:
City: State: City: State:
Zip: .. ... ----.-_-__--Phone: zip: Phone:
FEE SIMPLE TITLE HOLDER: t Applicable BONDING COMPANY: t 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 Countymakes 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 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 5t.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 jobsite
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.
LAI jP''
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Si ature of Owner/Lessee/Agent sig ture of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFCOUNTY QF
The fa ing instru ent was acknowledged before me The forgAing instrument was acknowledged before me
this, day of 20 (T-by this�day of .20 12. :by
(Name of person acknowledging) (Name of person acknowledging)
(Signa re of Notary public-State of Florida) (SifAdentification
Notary Public-State of Florida)
Personally Known �Ok nown 0 Pr d ce I n fI tion
Type of Identification Produce N ypP ug ,,Notary'Public•'State of FlprldS Lblic-State ar Florida
Commission No. "stmt'Comm.Exptrrs 1War 4 No. =• ” My Qq pins Mar 14.2018
Commission N FF 07 680 ".�,� � Commission p FF 1771680
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGE'T'ATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE