HomeMy WebLinkAboutBuilding Permit Application 07/10/2015 14:07 561-4932701 ECM PAGE 02
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date,--] 1 _ Permit Number:,51n1
RECEIV7D iUL 10 2015
Building Permit Application
Plonning and Development Services
Ruilding and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FC 34982
Phone: (772)462-1553 Fax.(772)462-1578 Commercial Re5liderltial X
PERMIT APPLICATION FOR: �~
Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: _1Q'P. t C
Legal Description:12eWV'- TO r=
Property Tax ID#: W oho' D3. OD14.3)0 Lot No. D J
Site Plan Name: ���(�V'. , VC.-t_e,4/T_H V, 0 I rtsa Block No.
Project Name: _. MCk Q(_ . V[A. &I 1►VA S'
Setbacks Front Back:. Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE HWH CHANGE OUT 'J-0CtY i C IrD incl. LA)V l
CONSTRUCTION INFORMATION:
itiona I work to �]GasTank
orrne un er ispermi -c ec a appy:HVAC ❑Gas Piping _Shutters ❑Windows/Doors
0 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq.Ft of Constructions�rr�� S�Ft'.of First Floor:
Cost of Construction_$ (�y`T' Utilities: I_ISewer 1:1 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Ir Name: ALAN LAFOY
Address: OY� l Ines Qtr Company: EAST COAST MECHANICAL
City: V00- ��t lcj,a State:FL Address: 1,500 N HIGH RIDGE RD
Zip Code: 3 AE1 sco Fax: City: BOYNTON BEACH __ State:FL
Phone No. 0,912— Zip Code: 33426 Fax; (561)493-2701
E-Mail. Phone No. (561)586-3739 EXT 2020 �r
Fill in fee simple Title Holder on next page(if different F-Mail. PERMITS@ECMSERVICE.COM
from the Owner listed above) State or County License: CFC048260
If value of construction is$2300 or more,a RECORDED Notice of Commencement is required.
07/10/2015 14:07 561-4932701 ECM PAGE 03
SUPPLEMENTAL CONSTRUCTION LIEN, LAW INFORMATION:
DESIGNER/ENGINEER: -Not Applicable MORTGAGE COMPANY: �Not Applicable
Name: _ Name:
Address: Address:
City: - - State: __ - Clay: State:
Zip: ... Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: „"Not Applicable
Name: Name: _ T -
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 Count, makes no representation+:hat is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any,applicable Horne Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult wit],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 guilding 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:Your failure to Record a Notice of Commencement may result in your flaying twice for
improvements t4 your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first;inspection. if yqu intend to obtain financing,consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature of Owner/Agent/Lessee ter' Signature of Contractor/License Holder �..r
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF PALMBaACH COUNTY OFPALM0-r14
The forgoing instrument was acknowledged before me The forgoing instru nent was acknowledged before me
this 10 day of S��L 20 l�by this t.> day of ��,20L by
S, GILLIAN CHUCK
ALAN LnFOY ALAN I-aFpY
(Name of person acknowledging GILLIAN CHLWX (Name of person acknowledging STATE OF FLORIDA,
NOTARY PUBOCC)mm#EE1M02
STATE OF FLOPICA t`3 vH Exr*es 4/7/201 S
Cam
(Signa re of Notary Public-State"t ridaJrArF;,;4/7/.101 tS
A(Signata of Notary Public-State of Florida)
Personally Known x OR Produced Identification— Personally Known. x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/1.5/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER R5VIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS