HomeMy WebLinkAboutBuilding Permit Application Miranda Plumbing&AC 7728710863 p.2
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ALL APPLICAPLE INF,0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED� i 5— Permit Number:Date V RECEIVED JUL 10 2015 Building Permit Application PlannIng and Development Services Building and Cade Pegulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR. To Select from dropbox, click here 19 Legal Descriptlon:,�-site Plan Name: Block No. �)l Project Name:Setbacks' Front sack! Right Side: Left Side:DETAILED-DESCRIPTION OF WORK: --Ilk rwn, Llsae CONSTRUCTION INFORMATION:AdditionalworKtone erformed under this perMTt—check all tll�apply'.L:?__ Gas Tank Gas Pip Shutters Windows/Doors Electric F7 Plumbing 17 Sprinklers Generator Roof 7otal Sq.Ft of Constructiool-4- SQ.Ft.of First Floor:cost of Construction:S L1, qq,00 Utilities:[I Sewer I:j Septlic Building Height:OWNER/LESSEE: CONTRACTOR:Name V Cii ,) Na Zip Code:q. 14Ciq V Fax-7 Phone No.- C
Miranda Plumbing&AC 7728710863 p.3
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SUPPLEMENTAL C.-NSTRUCTION LIEN LAWANFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: �Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phohe: Zip: Phone:
1
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: I Name:
Address: I Address:
City: 1 City:
Zip: Pho e: Zip: Phone:
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 installation has commenced prior to the issuance of a permit.
St. Lucie County makes r.o;epresentatlon that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with an 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 l 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 add!''ons,
accessory structures,swimirning 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
beforeAe first inspection. If you intend to obtain financing,consult with lender or an attorney before
comrhenWng work oY recording our Notice of Comm encemen
of 1
Signature of Owner/Agent/Lessee Signa re-Df ontractor/License Holder
STATE OF FLORID�A t, STATE OF FLORIDA
COUNTY OF .1 _�(_101 :: _ ;C�� 1 C'1G� COUNTY OF i�1� .�`—� 4 i CA a-
The f rg�ing instrument was acknowled ed before me o•`"""'��. The fo`going instrument was acknowledged before me
thise Cr day of 20=by �' ' f*�; thisl�day of y ;,��a
(Name of person acknowledging) y (Name of person acknowledging) g y
is
o C J t IV lV
(Signature of Notary Public-State of Florida) g v o (Signature of Nota ublic-State of Florida} s
R 01VIC �
Personally KnownOR Produced identification Personally Known Produced Identification
Type of Identification Prouced Type of Identification Produced
Commission No.y � G�; (Seal) Commission NoE (seal)
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Revised 07/15/2014
REVIEWS FRON I ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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