HomeMy WebLinkAboutBuilding Permit Application 7728710883 p.2
Miranda Plumbing&AC
'
ALLAPPLICABLE IN�OIVIUS_T BE COMPLETED FOR APPLICATION TO BEACCEPTED
DateS7 Permit Number'- ISO q O�LM
Building Permit Application
Planning ond Development Services
Building and Code Regulation Division
2300 Virginfer Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click here
Address: Lnfe_
Legal Des 1ptio ri��,
Property Tax ID#: LIM Lot No
Site Plan Name, Block No.
Project Name:
Setbacks Fro nt 22ck, Right Side: Left Side:
DETAILEDDESCRIPTION OF WORK:
CONSTRUCTION
Additional work to be erformed under this permit—check all that apply:
CHVAC Gas Tank Flas Piping Shutters \Nlndows/Doors
11 Electric Z Plumbing ESprinklers Generator Roof
Total Sq.Ft of Construction, So.Ft.of First Floor:
Cost of Construction, A Utilities:0 Sewe r 7 Septic Building Height:
OWN.ER/LESSEE: CONTRACTOR:
Address: Company: reA_
Zip Code- Fax: City: P-0 ),7- State:
Fill in fee simpleTitle Holder on next page(if different E-Mail: OC*L4c,-, teLcerh�,-CZ()Ct,--CC-,'-"Pr"nl--;5, ccx(n
from the Owner listed above) State or County License:
If value of onstruction Is$2500 or more,a RECORDED Notice of Commencement is required,
Miranda Plumbing&AO 7728710863 p.3
DESIGN ER/EN GINEER.-. Not Applicable MORTGAGE COMPANY: NotApplicable
Name: Name:
Add ress: Address:
City: State: City: State;
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
Zip: Phone: Zip:
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.LucieCountv 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 Home Owners Association rules,bylaws or and covenants that may restrictor prohibit such
structure.Please consultw.ith 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 app i:roved plans,the Florida Building Codes and St Lucie County Amendments,
The following building permit applications are exempt from undergoinga full concurrency review: room additions,
accessory structures,swim.ming 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 youn property. A Notice of Commencement must be recorded and posted on the jobsite
befor.e.th,e first inspection. If you intend to obtain financing, consult with lender or an attorney before
commenNng work or recording your Notice of Comma cemen_t�
Signature of Owner/Agent/Lessee Sig natki re_df:�_qntracto r/License Holder
Ing
The forgq instrument was acknowled e beforerrie,%!,4�&.N,!,, The forgoing ins
U=ent was acknowledged before me 1q;V- .4
20 by .53 this
20 by
Ja
me- per—son ar C-1 PprEcn acknowledging)
C�p CD
7 .
4Signature of Notary Public-.state of Florida (Signature of Notary Public
Personally Knowk_'_�.OR Produced Identification Personally Known f®R Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. ).1 3�0731�-- (seal) Commission NoEEc�a/)3�;— (Seal)
RevLsed 07/1512014
REVIEWS ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE
REVIEW REVIEW REVIEW REVIEW MANGROVE
DATE REVIEW REVIEW
RECEIVED
DATE
COMPLETED