HomeMy WebLinkAboutBuilding Permit Application FAL!APPLIC�4B E INE(?:. UST BE_COMPLETEO FOR.APPUCATIC?N TOZE ACCEPTED.
Date: Permit Nurriber, �
Bulldin Perrm Appli at on
Planning and Development Services
Building and Code Regulation Division
2300 Wginid Avenuei Fort Pierce.FL 34982
Phone:(772).462 1553 Fax:{772.)4624578 Commercial Resi.dentia9
PERMIT APPLICATION FOR`.. Mechanical.
PRUPaSED 11VPRiJVEfVlEN7 LOr~ATIi 4 =
Address:
l.egai,.Description:
Property.Tax ID#: �-� ` i� Z ��'' p' Lal No_
Site Plan Name:' Block No'.
Project Name
Setbacks Front Back:. Right Side: Left.Side:
I . Tll � oEse�IP-rloN.al^wog
CONSTRUCTIt)N INFQRMATl0N
itiona wo _to e performed under this permit-C eC a appy:
�,HVAC be
Tank Gas Piping �Shutters Q Windows/Doors
Qelect,ric! Rlumbing.' Sprinklers Gerieratpr. Roof'
Total Sq.Ft of Construction: S .Et.of First Floor: .
Cost.of Construction:$. 3 X`7 Utilities: Sewe. rF—Septic Building Height:
QWN ER/LESSIEk CaNTRAGTQR.
Name. �-1( - � �' `D if Nam : THEODORE MANN .
Address:.�2,&1C)1 Kl. -.3 �'.n an(1�r'1:N company .AC:MANN,ING
City �+�`^y► `C State:FL Address: 1050 SW BILTMORE STREET
Zip Gone; Fax: city: PORT ST LOCIt State:FL
Phone.No. - Zip Code. 34983 Fax-
E-Mail: Phone.No. 772-340 #6.04
Fill in fee simple Titie:Flolder on next page(if different .E-MIil:..,pslac:mann@aol.com
from the'Owner listed above] State lir County License: CAC1814425 C1814?i25
if value of cori"struction is$2500 or more;a RECORDED Notice of Commencement is required.
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StlPi ML XS L#ENSSAW INFORCVIATION
0'7 +," rr a �a ctr�,ra
xyl.'ki,n sx„§+i n
DESIGNER/ENGINEER: - Not Applicable MCIRTGAGECOMPANY: Not Applicable
Name: Name:
Address: Address:
Pty:. State: City: State:
Zip: Phone: ZIP: Phone:
FEESIMPLE TITLE HOLDER: Not Applicable. BONDING COMPANY: Not Applicable
Name: Name:
Address: _ Address:
city'-
Zi P'
ity:Ztp: Phone: Zip:T Phone:
OWNER f CONTRACTOR-AFFI.DVIT.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 permit.-
St:Lucie Count�yy 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,.bylawsor and covenants that may restrict or prohibitsuch
structure.Pleaseconsult with:your Nome`Owners Association and review your deed.for restrictions which may apply,
Inconsideration 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 Floricla Building Codes-and St:.Lucie County Amendments.
The.following'building.permit applicatfons:are exemptfrom undergoing.:a full concurrency.review:.room additions,::
accessory structures;swimming pools,,fe.nces,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 payingtwice.for.
improvements to your property.A`.Notice of Commencement must be recorded and posted on the-jobsite
before the first inspection. If yo.0 intend to obtain.financing,consult with lender or an attorney before
commencin work or recordin our Notice`of'.Commenceirient.
i
Signature of Owner/Agent/Lessee Signature:of Contractor/License Holder
STATE OF FLORID. / , STATE OF.FLORIDA-
COUNTY OF. Liae j � COUNTY OF
The forg ing instru ent was acknowled ed before me The for oing instru nt was acknowledged before me
thiay of .' 20�by thi�ay of 20UDby
Qpdo�e lI3'1 _h r T an r--).
(Name of person acknowledging) (Name of person.acknowledging)
(Signature of Notary.Public-State,ofTloOda). (Signature of.Nota.ry Public-State.of.Flonda.)
Personally Known OR Produced 11clentification Personally Known V OR Produced'Identification-
Type.of Identification Produced Type:of:IdentificationProduced
Commission No. (Se® ORAH RUSSELL ommission No
,'a°`, Notary Public-State of florid ;•otaRy pt, DEBORAH RUSSELL
_ :a. ,�= Notary Public-State of Florid
.N• «Y� SN* *.•.=MY Comm.Expires Nov 30 201
;9r ¢�• Commission #FF 179630
Revised 07/1M01 '�;P, ;, �,�°}F4°� Commission#FF 1796 t0
Bonded through National Notary Assn. ' ... .. Bonded through National
�� .�.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA.TURTLE: MANGROVE
COUNTER REVIEW. REVIEW REVIEW REVIEW REVIEW REVIEW
DATE .
RECEIVED
DATE:
COMRI.ETED