HomeMy WebLinkAboutBuilding Permit Application Jul• 20. 2015 2:08PM Barker Air Condition 7725625340 No• 9809 P. 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION Tp BE ACCEPTED
Date: Permit Number:
Building Permit Application RECEIVES
Planning and DeveloptuentServices JUL 2 0 .2015
Building and Code Regulation 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 arrow at the end of line
PROPOSED IMPROVE MENT10,CATION:
Address: Vo y+
Legal Description: — uqo V C�,
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Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front— Back:. Right Side: Left Side:
DETAILE!].D•ESCRIPTIQN OFIJDR
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AC Gas Tank FiGas Piping _Shutters Windows/Doors
Electric Plumbing ❑Sprinklers Generator F-1 Roof
Total Sq. Ft of Construction: SCI. Ft.of First Floor:
Cost of Construction:$ J 91 . a Q Utilities:OSewer[]Septic Building Height:
OWNERESS,EE: :.,,: 9 „s y� , x;.; ; ; u .•�.`;;;,<„ .. .,., >
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Name L OL.6_S Co ) y r)n a Name Q v Y
AddressAar)_ _le. bvtvet Company:
City:+ Y-3 Cr. , Stater, Address: q
Zip Code:,3 41; 1 _ Fax: City:VQyn I ra a-_% Staterf.
Phone No. zip Code:•^-S' ?,•,q l OX) Fax--1"1"Z• 5102• ]�&4b
E-Mail: PhoneNo.—TIT. OLD-Z. Z1Q2% lam
Fill in fee simple Title Halder on next page(if different E-Mail:
from the Owner listed above) State or County License: CAC925-10 E5 2-
1f value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Ju1. 20. 2015, 4; 31 PM Barker Air Condition 7725625340 No. 9827 P. 2
.SUPPLEMENTAL CONSTRUCTION: 1EN.LAW.'INFO.RMATIOIV;
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: Not 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 ermit 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 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:Y ur failure to Record a Notice of Commencement may result in your paying twice for
improvemen to your p o erty.A Notice of Commencement must be,recorded and posted on the jobsite
before the frfst inspecti . 1 ou intend to tain financing,cult wit nd r or an attorney befo
com i wor r re ordin o ice of Comment e .
. s
_Signature o Owner/Lessee/Age Signature of Contracto cense Hol e
STATE OF FLOFUDA STATE OF FLORIDA
COUNTY OF tsar-- COUNTY OF If LLL"r
The f going instrtr megt was acknowledged b ore me The forgoing instrument was acknowledged before me
this�day of J u! 20 / by thisou day of JVA ,20 1 S by
M J
(Name of person acknowledging) (Name of person acknowledging)
ig e f Notary Publl -State of FI i ( atu a of Notary Pub -State FI rida)
Personal/ Known_ Produced Identific Personal Known Pub
Producgri Y IY
Type of Identifi Type of Identificatio P R _ d L RPI
• • : MY Cb1NMi5SIC1Pi*FF24f286
Commission No. =" MY coMMissl I:24126G Commission No. cc��''��
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Revised 07/15/2014
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