HomeMy WebLinkAboutBuilding Permit Application Miranda Plumbing&AC 7738710863 p.2
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ALL APPLICABLE I�NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: PermitNumber:
Building Permit Application
Planning and Devetopment Services
Building and Code Reguiction Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSED INPROVEMENT LOCATION:.'
Site Plan Name: Block No.
Project Name:
Setbacks Front_ Back!_Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
A dition orktobenertormed under this permit—check all 0251 apply:
IJ'HVAC F�Gas Tank [:]Gas Piping Shutters Windovis/Doors
11 Electric 17 Plumbing 75prinklers Generator Roof
Total Sq. Ft of Construction: SQ.Ft.of First Floor:
Cost of Cc nstructio n: Ut,,,,i,,:Ei SewerF]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
City., ��e-� State, AddrAs:- x\
,Ve
Zip Code,
Phone No.'
Fill in fee simple Title Holder on next page(if diffe nt(fol f't
from the Owner listed above) I State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required,
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Miranda Plumbing&AO 7728710883 p.3
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DESIGNER/ENGINEER-! Not Applicable MORTGAGE COMPANY: Not Aoplicabie
Address: i Address:
City: State: City: State:
Zi p: Phone: Zip: Phone:
FEE SIMPLE TITLE HOL.DER: Not Applicable BONDING COMPANY: NotApplicable
Name: Name:
Address: Address:
City-, City:
Zip: Phohe: Zip; Phone:
OWNER/CONTRACT`(Y,R 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 cornmenced prior to the issuance of a permit,
St.Lucie Coun t ma<es no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conrlict with any applicable Home Owners Association rules,bylaws or an enants that may s rict or prohibit such
structure,Please consult with your Home Owners Association and review your deed?.Cr:oa"n restrictions ch'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 app'roved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building perr�it applications are exempt f rom undergoing a full concurrency review:room additions,
accessory structures,swinirning pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNEk: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-tbe first inspection. If you intend to obtain financing, consult with lender or an attorney before
SiBri�ature of Owner/Agerill/Lessee Signatiure-df'-C�2ntractor/License Holder
STATE OF FLO STATE OF FLO
COUNTY OF COUNTYOF
The fo Ing cknowled red before me The forg9pg ln!tr�ln�tjt was acknowledged before me
th'is day '20 64S thisi '20
T no
(Napie of person acknowl6dging �5 (Mrne of person acknowledging, CD CD
(Signature of Notary Vublib-state of Florida 2; (Signature of Notary Public-State of Florida)
Personally Known_��OR Produced Identification L Personally Known L_-'-� 6R Produced Identification
Type oNdentification Produced Type of Identificatlion Produced
Commission No. (Seal) Commission No. (Sea])
Re-v ised 07115120 14
REVIEW5 FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTk REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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