HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1150.0
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Building Permit Application
Planning and Development Services
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: Mechanical
PROPOSED INPROVEMENT LOCATION
Address: 10 np 71
Legal Description:
Property Tax ID#: r7 L- CSS 1005L - CLQ -Q Lot No..
Site Plan Name: Block No.
Project Name: 11(1.Lc��led-IC C
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
CONSTRUCTION INFORMATION:
itiona wor to e e orme un er this permit-check a a appy:
VAC []Gas Tank ❑Gas Piping Shutters. ❑Windows/Doors
Electric El Plumbing I Sprinklers E]Generator 0 Roof
Total Sq. Ft of Construction: '�S L1 V Sq. Ft.of First Floor:
Cost of Construction:$ go-eDc Utilities: Sewer ElSeptic Building Height:
OWNER/LESSEE CONTRACTOR
_.
Name me,fj Name: RALPH WARREN
Address: 1.399`-i . -` ►G2n 2iJe� Company: AIRFLOW A/C AND HEATING
City: State:FL Address: 50 NE DIXIE HWY SUITE D-1.
City: STUART
'34'q57 7Fax: Ci
Zip Code: ' State:FL
Phone No. f2 R -_,3b6-k\Q Q Zip.Code: 34994 Fax:
E-Mail: ------ Phone No. 772-781-2665
Fill in fee.simple Title Holder on next page(if different E-Mail: airflowacfl@gmail.com
from the Owner listed.above) State or County License: CAC1817930
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
n
,:SUPPLEMENTAL DESIGNER/ENCONSTRUCTi N LIEN LAVH iNFORMATtON,
, s-,
GiNEER: 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: f
City: City:
Zip.' Phone: Zip: Phone:
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.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure f"
which is in conflict with any applicable Home Owners Association ruies,'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 g-anting of this requested permit,I do hereby agree that I will,in all respects,perroim 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 tor obtain financing,consult with lender or an attorney before },
cQMmencing work or recording your Notice of Commencement.
Signature o Owner/Agent/Lessee Signature1of Contractor/Licerise Holder
STATE OF FLORIDA t STATE OF FLORIDA k
COUNTY OF S� 0_�CdLC-+�(= COUNTY OF ., a e_
I The for Ding instrument was acknowledged before me The for o'ng instrument was acknowledged before me
thi day of. <;�_ 20-0 by thi Say of .20�` by
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LE In
(Name of person acknowledging) (Name bf person acknowledging)
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t
(Signature of Notary Public-State of Florida) { ignature of Notary Public-State of Florida) •
Personally Known ✓ OR Produced Identification Personally Known 'V' OR Produced Identification i+
Type of identification Produced Type of Identification Produced fj
3i
Commission No. 1,111111,,,, p&Q*H RUSSELL Commission No. s
Notary Public-State of Florida � RAH RUSSELL i
.`'i*aY uB'
2* ; qmm.Expires Nov 30,2018 ,20* ,°� Notary Public-State of Florida
Commission#FF 179630 ;.* ;•_Niy G'amm Expires Nov 30,-201
Revised 07/1 S/2 1 ''„�,;;; �' o,� Commission#FF 179 630
Bonded through National Notary Assn. , P�,
Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE ��
RECEIVED i
COMPLETED