HomeMy WebLinkAboutBuilding Permit Application Date: Permit Number:
RECEIVED
Building Permit Application
Planning and Development Services JUL 2015
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential 110
PERMIT APPLICATION FOR: Mechanical 41 xo
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Address:_gc2OO C. nez.#"011 Z4tne
Legal.Description: 524 l-vz�41- C," plag4_-,tU
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Property Tax ID.#: 41 ,25— 70/ Q/Y/ OL90 -3 Lot No. 1,
Site Plan Name:. /-44 Block No. 2
Project Name: zda, 2 -.� o4z'
Setbacks Front Back: Right Side, Left Side:
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AClaitional work to beroRfied dhi&U apply:
Electric
Gas'Tank F]Ga.s Piping Shutters E]Windows/Doors
Plumbing Sprinklers Generator Roof
Total Sq.Ft of Consftuction, Sa.Ft.of First Floor:
Cost of Construction.S. Utilities-.E]Sewer E Septic Building Height:
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Ph6riAo. ABYb3%Q Zip Code: Fax:,22? Y�gT .97,'�R
E-Mail: Phone No.. '=d " ) S1112-1- 1
Fill in fee simple Title Holder on next page(if different E-Mail, S11 %r"n r
from the Owner listed above) State or County License:_J L4LtALe___
If value of construction is$2500 or more,a FtECOROED Notice of Commencement is required.
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DESIGNER/ENGINEER- 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: of 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 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 with your Home Owners Association and review your dead for any restrictions which may apply.
In consideration of the granting'of this requested permit,I do hereby y agree that I will,in all respects,perf6'rm 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: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 your Notice of Commencement.
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Aignaturo of Owner/Lessee/Agent Si nature of Contractor/License Holder
COUNTY
TATOF FLORIDA</ STATE OF FLORIDA
COUNTYOF -..-J C, COUNTY OF
The foloing Instrumentwas acknowledged before me The fopoing Instrurrignt as acknowledged before me
this.L:�� day of_, CA4 . 20 aby thisLL day of J&&) �, .20 L,-J by
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(Name of person acknowledging) (Name of person acknowledging)
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(Si ature of Notary Public-State of Florida) 061ure of Notary Public-State of Florida
Personally Known OR Produced Identification Personally Known-OR Produced identificationType of identification Produced entification Produced
personally
SANDRA HCH
• Notify Public-3 09EWW"s 'on No, (Se3*0RAmom�fjjj
Commission No.
My Gomm.Expires M r Notary Public-44ft Of FlOfida
F 07ieeo MY Comm.Exgo
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N31100 NOMY ASS'- Qg. Commission#FF 671690
Revised 07/15/2014 'Nough wlaw Wmy Asso,
RFViFWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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