HomeMy WebLinkAboutBuilding Permit Application From:Advance AC LLC Fax:(877)662-7942 To: Fax: +1 (772)462-1578 Page 1 of 3 0713012015 4:02 PM
ALL APPLICABLE INFO MUST BE'COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:. � �� Permit Number: )l, ISO
RECEIVED JUL 3:12015
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 Lam/
Phone:(772):462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line J
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Address: : , 4Vogz(Yci
Legal Description:
Property Tax ID#: 3 S �' d�C1 9" o od- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additio a `wor to be e.orme under this permit-c ec a appy:
HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
Electric 0 Plumbing []Sprinklers [Generator Roof
Total Sq.Ft'of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ Utilities:0Sewer 0Septic Building Height:
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Name M..°.r C, C,,4e,—Ce- Name: I mo,
Address: � ."v� �� �'f Company:. �G�n C,vAll
City: Stater Address: 400D .off: G JG
Zip Code: S Fax: City: # o; State.:
Phone No. r - bit Zip Code: �1 U"L( Fax:
E-Mail: mG vl I VA r~ Phone No. 1$11 -(1 i -1 Vit!'
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Fill in fee simple Title Hoer` n next page(if different E-Mail: ria tirt£Q c�:C I C {li%'fjs h . C001
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from the Owner listed above) State or County license:_— 11t
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Ifwalue;af;construction:is:$2500ar::Two RE.CORDED.Notice o#:CommeWIT110 J5:r.�quired. .
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From:Advance AC LLC Fax:(877)662-7942 To: Fax: +1 (772)462-1578 Page 2 of 3 0713012015 4:02 PM
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DESIGNER%ENGINEER: _Not Applicable MORTGAGE COMPANY: _.Not Applicable f
. Name: Name:
Address: Address:
City: 'State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: �61�Not Applicable BONDING COMPANY: of 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 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.
in consideration ofthe granting of this requested permit,I do hereby agree that.)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: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 to obtain financing, consult with lender or an attorriey before
commencing work or recording our Notice of Commencement.
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Signature o ~/Lessee/Agent Signaturto Cpn or/License Holder
STATE OF FLORIDA ,- STATE OF FLORIDA
COUNTY OFA' ,�C"[k- COUNTY
The f r oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of_ _ 20 by this `A day ofUi V!t 20 by
(Name of person cknowledging) (Name ofpvn nowledging)
YA -1
(Signatureraf Notar ub' (Signa re of'1Votafy Public-State of Florida)
iG1y��F229290 ,
Personally ,n �d cyd�¢�}f�f"ca 'on V Personally r, yc.�titica ion
Type of Ide i It �ProdthE �. Type of Ide i ;Pro ajob, 29204
Commission m7p. 5s _ (Seal) Commission T EXPIRes May es ZD19
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA.TUR..TLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE.
IT ALS .. ... . .
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