HomeMy WebLinkAboutBuilding Permit Application Jul 20 1502:35p Grossmann AirOond0onin 772-3980727 p2
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPE ICATIONTO BE ACCEPTED
Date: PermitNumber,
RECEIV�El 21 20b
Building P rmit 4plication
Planning and Development Services
Building and Code Regulation Division
2300 Wryinio A venue,Fort Pierce FL 34-992
Phone: (772)462-1553 Fax:(772)462-1578 Cohnmercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATIOU:.'
Address: ALe
PropertyTaxlD#: Lot No
Site Plan Name: Ymn 4+her-oN Block No. I q
Project Name:
Setbacks Front Back: Right Side: Left Side:
CONSTRUCTIOUINFORMATIOW
Ellectric F1 Plumbing 0-sprinklers F Generator F]Roof
Total Sq-Ft of Construction: 5cl-ft-offirst Floor:
Cost of Construction: Utilities: R Sewer E]Septic Building Height
OWNEk/LESSEE: CONTRACTOR:
Fill in f le Title Holder on next page f if different E-Naik q I—&I 11)CA C—ce—L)e-a M a I�Y o
from the Owner listed above) State or Founty License: '2-'b'7
is$2SOO or more,a RECORDED Notice of Coma encement is required.
Jul 20 15 02:35p Grossmann Air Conditionin 772.3989727 p.3
'SU PPLEMENTAL C-ONSTRUCTIGN UEN LAW NF0RMATION:
DESIGNER7ENdwEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name.-
Address: Address:
City: State: City: State
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE BOLDER: Not Applicable BONDING CC2MPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
t certify that no work or installation has commenced prior to he issuance of a permit_
St.Lucie Count makes no representation that is granting a p unit will authorize the permit holder to build the subject structure
which is in conflict with any applicable home Owners Associa ion 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 des and St_Lucie County Amendments.
The following building permit applications are exempt from u dergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,scfeen 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. lflwu intend to obtain financing,consult with lender or an attorney before
commencin k or recop&g your Notice of Commencement.
X.
Signa � Slgnat 'Co Tact&/Lic nseHolder
��
STA Ir ORIDA ST=F/LORIDA
CO OF �'' /C t'�c COOF — } 4 C'.i
"rhe forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this?D day of. j„ ZO /,5 Uy this 4'' day of UL,,. 20 to by
(Name of person
/a/cknowledging)- (Name of person acknowledging)
(Signature of Nc'>Ftary Pi lic-State of Florida) (Sigtture of N-AaWPublic-State of Florida)
Personally Known �- " OR Produced Identification Personaliy Known f OR Produced identification
Type of Identification Produced Type of lt7entification Produced �
Commission No_ l�J J�_ � l «�
(Seal) Commission No. �- r z.., (seal)
Gail H. Gende
,•�. F;,•. Gail H. Gentle ,,��* �"w,
,�_ A#,F 1&370ii
Revised 07115/201 2 � ,Eicpiras:Jtcldi.t5,2ot8 =��OFft - E7cliir�;:.tAAtt512D18
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REVIEW5 FRONT ZONING 5UPERVISOR FLA 5 VEGETATION 5EA TURTLE MANGROVE
COUNTER REVIEW REVIEW Ri;V14W REVIEW REVIEW REVIEW
DATE
COMPLETE
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