HomeMy WebLinkAboutBuilding Permit Application Miranda Plumbing&AC 7728 10B63 p.2
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATI ON TO BE ACCEPTED Date, CJ Permit Number.Building Permit Application Planning and DeveiopmentServIces Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone-(772)462-1553 Fax:(772)462-1579 Commercial Reside ntial -V/1",PERMIT APPLICATION FOR.' To Select from dropbox, click here Property Tax ID Lot No.Site Plan Name: Block No, Lr'2)Project Name'.Setbacks Front— Bark, Right Side. Left Side:DETAILED DESCRIPTION OF WORK;CONSTRUCTION INFORMATION.,Additional worKto be oerformeci under this permit—cFe-ckalF-that Electric Plumbing []Sprinklers Generator Roof Totai Sq. Ft of Construction; SO.Ft.of First Floor:Cost of Construction:$ Q—(5---0 b Utilities Sewer FISeplic Building Height:OWI�ERAESSEE,. CONTRACTOR:Ad ss: Company:zipco City: StateFill in fee simple Title Holder oi Vt cpla 9 6 ifferpa Pt from the Owner listed above) State or County License:0 Kk5,4Ki If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required, ~�
Miranda Plumbing&AC 7728710863 p•3
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SUPPLEMi" ITAL.0: NSTR:UCTION'°1lEN'.:lAlt1( NF£)FtIVfATIC}.N::`.:,,
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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: f Name,
Address: 1 Address:
City: City:
Zip: Pho e: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no presentation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with an pp
Homeowners Association rules,bylaws qr and covenants that may restrict or prohibit such
structure.Please consult w�t�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 peri ilt 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 you property.A Notice of Commencement must be recorded and posted on the Jobsite
befor a first inspection. if you intend to obtain financing, consult with lender or an attorney before
commen `n worts or decordin our Notice of Commencerne '�.
Signature of Owner/Agent Lessee Signa re-oY--C.onntractor/License Holder
STATE OF FLORID l STATE OF FLORID
COUNTYCIF COUNTY OF -`al
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The f ing in rument was acknowledged before mei yys.kQ The far oing instrument was acknowledged before me
this- day of 200 by ?�= this day of 20®by $r;
(Name of person acknowledging) (Name of person acknowledging
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(Signature of Notary Public-State of Florida) o o (Signature of Notary Public-State of Florida) cn
of ut�
Personally Known L' Produced identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission Na.L (Seal) Commission (Seal)
Revised 07/15/2.014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE i
RECEIVED
DATE
COMPLETED
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