Loading...
HomeMy WebLinkAboutBuilding Permit Application From:Air Repair Solutions,IFax:(800)757-0066 To: Fax: +1 (772)462-1578 Page 2 of 4 07/21/2015 10:39 AM ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO'BE ACCEPTED Date: ! ,4-\: AS' Permit Number: Buellding Permit ApplicationPlanning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 �f Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential h PERMIT APPLICATION FOR: To Select from dropbox, click arrow'at the end of.line �����iJ7 ����l��l ����u4+-M��T�1..�!/A�I`�� ,.�''� 'wj .Li y.: 4 �c Tk-4 �; � .�. y�y.3. � R y.. j ,�'-•,y N}-' �' -- :su,+..,..�. .�,.�..t:.�. _ _,,.,�' r„•x.,,,'�.»� ,�, ,.� ,� �'c `'= >'z�:...�.,"•"�C,. '`��" s.� �:.r,�„TM c�a x Ja s�,-u.�,�•4_yv- Address: Lega(Description:�„(�/�'�`•t`�•' �r�Q�` ” �� t� �,�, �" LEI�•��`�I �'�C3 �tiC'1� 1��,�Q�.— Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks^ Front Back: Right Side: Left Side: .s:. y •� ��� � SCRI RTlO L£CSF cG:,R� "�' 'F� � r rtt- �t r zs w .vaF' ..,; +tv' m,` ;: ''Y...:,x�• rtr.��hx'1 F w ; - i �. 'a .# �!'�-� ,a _r r I t x itch w u f fl t _ .. .,,,sesN� ,�...; $ ..., :,.:rrr`k,.__.1 ��:rr::.r, xf; a�'i.' '��'+_' ,•,xis �{�..+4 ,.. I'�,�TR�CTIC,�N IN�FORf��TiOl�lfr ! .fi�.z.,• n .:_...:. ,,,,n..,,rmir,v�...vxat3 �.'E.^+.1.'?S; _.K:: �:;9ui1 R:r ,� i'�f;tift, bt, .T' �. tA., .sl,�r,� >� fi ir4�,'. 4,+/` !"�F7t �h'u+' >r..,,: .. ..,.. .......w+� _.,........ ,.r,�. :-.3' ,,.•.,.. �, ..fir.>•: •,.,.�Jt,k� -tir..=•fit '. r .�gfs A itlona wor to bene orme under this permit—check a apply: - HVAC L_J Gas Tank ]Gas Piping Shutters L1 Windows/Doors nElectric F]Plumbing ❑Sprinklers El-Generator Roof Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ � �� Utilities. Septic Building Height: ✓� ©`/.. '� d G ! �A J J71 t4T�'CAJ SY?. —fJ t fE... '!; r _�__"i>,z-:. ., _._,,. T�: ., .= .fxw,v,.:_ ».,��- _�Yr`•�"�`�h.J.Nr_.M: _�v..,...: �rx. ^�-. �, ,_,,..xr.l4 ss:--..�.w<i _azo--. ..:Y..� ..��„�..-.,.,� r; Name Name: Addresrcs� a.� � _ Company: � n (' City:_ Stater Address . J .'Zip'Code: Fax: City_ pI~� . �I� State,- Phone No.-7,'l;).—(A1;) Zip Code:_ :. Fax:. � `1 - - ' B E-Mail: Phone No... Fill in fee simple Title.tlolder on next page(if different E-Mail: from the Owner listed above) State or County License: L(• G If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. From:Air Repair solutions,[Fax:(800)757-0066 To: Fax: +1 (772)462.1578 page 3 of 4 07!2112015 10:1 39 AM DESIGNERJENGINEER: ,,,�Not Applicable t1lIORTG�.GE COMFAIVY: �Nat Applicable Name: Name: Address: Address: City: State: City: State: Zip; Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: KNot 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 makesno,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 restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrictions which may-apply. Inconsideration of the grantirtg.of this requested permit,I do hereby agree that I will,in ail 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:Your failure to Record a Notice of Commencement may result in your paying twrice 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 our Notice of Commencement. s Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORID ,.. COUNTY OF � . ua e- COUNTY C Wli!: ,.. The forgoing instrument was acknowledged„before me The forgoing instrument was acknowledged before me this. day of M11, 20 I5by this 2L day of 0I t,4 20 IT..by (Name of person acknowledging) (Fame of person acknowledging) (5igna r of'Notary Public-State of Florida) (Signatti f Notary, Public tate of Florida) Personally Known �OR Produced'Identification Personally Known OR Produced Identification Type of identificatio�h Produced Type of Identification Produced .«StYPttg °ZPRYPU8 HOLLYNICOLEX INSKI z°:..•.'4o HOLLY NICOLE KUL1NSKi r e ;o� Commission No.. � 0", 10gyCOMMIS$ION2FF-14273 Commission Na. �� ,, (`56Wftf8$ION#FF142732 EXPIRES:August 5,2018 N, EXPIRES-Augusts,2018 � BmdedThruBudptN01NySeMCe � q9 usudgetNalarysigims sig Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEAT.URTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW .REVIEW DATE COMPLETE INITIALS