HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE:INFO MbST BE coMPLETEO EOR APPLICATION TO BE ACCEPTED (�
Date: Per: Nurntier, C:1
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Buli>r>� P�lrtt Appliction
Planning and gevetopment Services:.
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce.FL 34982:
Phone:(772)462-1553 Fax:(772),462-1578. CO.Mmercial ' Residential V
PERMIT APPLICATIC?N.FOR," Mechanical
:PROP C1SED 1NPoENlENT LOCATION;_
Address: C%C�
Legal Description;, i G �' g
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Property Tax ID'#: s 4 4,22 Lo R30 CXD(5 000 Lot No
Site Pian Name: ` ► Biock'Nb::
Project Name: 'Y Q sq.- ieltk.I
:Setbacks- 'Front . Back: Right Side, LeftSide:
C3ETAILED DESCRIPTION t7F WtRK
CL
C Q Se,r'
C }NSTRUCTIQN 1NF�ORNIATt0N
itiona wo :to e e orm.ea under this perrnit—check a app
RIHVAC Gas:Tank EIGas Piping Shutters Q.Windows/boors.
Eldctrr`c Q Plur-hbing. QSpri016rs Generator �Roof
Total Sq.Ft of Constructions:, Sq.-Ft.of First Floor:
Cast of.Construction:$ . `^! 671Cb,co Utilities: Sewer[leptic Building Height:
..OWNER/LMEE :CC3NT RACTC3R
NaMarne:
me: TNEODOREMAiNN
Address; 1 jca ,".� an Company AC MANN INC
City "j%7In lt?.r State: Address. 1.050 SVV i31CTMORE STREPT
Zip Code: i"1 ... Faxr City:.PORT ST LUGjE: 5tatei FL
Phone;'No: .�`,2 .'aLA G ' Crz G Zip Code: 34983 Fax
E-Mail: --------- Phone No. 772-340-4604
Fill.in fee simple Title:Holder on next:page(_if different E Mali; ,psiacmann aol;coni _
... _
from the Owner listed a6oue) . ' State or County License::CAC181442-S
if:value of construction:is$2500 or more,a RECORDED Notice of Corhmencement is.reciuired.
SUPPLfNiENTA>=CONSTRUCTION LIEN�LAW iNFORMATIOiN
{
DESIGNER ENGINEER::. Not Applicable
—. pp MORTGAGE COMPANY: _Not:Applicable
Name: Name:
Address: Address: .
City State: City State:
Zip':` .. Phone: - Zlp; Phone:
FEE SIMPLE TITLE HOLIbbU Not Applicable. BONDING COMPANY: _Not Applicable
Name: Name: .
Address:
.Address:
City: . _ C.
Zip: Phone: Zip: . Phone:
OWNER/CONTRACTOR,AFFIDVIT.;.Application is hereby made to obtain a.permit to_do the work and:installation as indicated:::
I:cgrtifyahat no work or installation:has commenced.prior to the issuance:of a permit. .
StC:Lucie Co=ma no:representation that is granting a permit.wiil authorize the permit:holder:to build:the subject structure:
which is in con ict',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 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 permit:applications are exemptfrom undergoing a full concurrency-review:room'additions,:
accessorystructures,swimming pools,fences,walls,signs,screen rooms and.accessory usesto another non-residentialuse
WARNING-TO OWNER:Your failure.to.Record a Notice of Commencement may cesultan your paying twice for
improvements to your.property.A Notice of Commencement must be.:recorded-and posted.0nthe jobsite
before the first inspection. If,you intend to.obtain financing; consult with lender or an attorney before
commencin .:work Or'Tecordin our.Notice of Commencement.
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.Signature 'f Owner/Agent/Lessee Signatur of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF: j5j, COUNTY-OF
The.forgoing instrurnent was acknowled ed before me The for ing instrument was acknowledged before me
this.1j j day of , -t 20by thisi ay ofi isiL 20mby
e o/_i ipr'e M am yi -t`�1e 0d c -e 1` &n
(Name:of person acknowledging:) (Name of person acknowledging:)
Si nature of Nota Public-State of Florida (Signature.of Nota Public State of Florida
( g Notary ) g �Y. )
Personally Known OR Produced Identification Personally Known OR Produced identification
Type of Identificatio Type.of Identifica#ion P oduced
DEBORAH RUSSELL
Commission No. '�•
No {{{� -
Corrsmission No. : °taR�"�o'' q �1H RUSSELL
y� �) State,of Florida r ¢� Notary Public State of Florida .
My Comm.Expires Nov 30,2018 * «+ My Comm.Expires Nov.30 20
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Bonded through National Notary Assn. ommission #FF 179630
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Revised 07/15 04 4 ""'"• Bonded through National Notary Assn
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REVIEWS FRONT ZONING SUPERVISOR : PLANS VEGETATION. SEA TURTLE MANGROVE .
COUNTER REVIEW REVIEW. REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE,
COMPLETED.._