HomeMy WebLinkAboutBuilding Permit Application 09-17-15;22;22 ;From: To:7724621578 ; 7724618722 # 3/ 4
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Permit Number: �q /�Liz
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mman �AMAI '
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fart Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Project Name:
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MVAC �Gas Tank ❑Gas Piping _Shutters �Windows/Doors.•
Electric Um ng Sprinklers Generator Roof
Total Sq. Ft of Construction: SQ. Ft.of First Floor:
Cost of Construction:$ .bD Utilities: Sewer Septic Building Height:
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NameL moi/ Name: t4n71 .�
`Address :S_3/O /7 //T4 CompanY:�` 1a
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'City;. o i '�" ;1 oil
Stater Address:SDS,: jlr �► /
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Code: .3 Fax: State:Fl,
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E-Mail:_ _— Phone No. _ 2- ---
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
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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:, Nat 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 Count 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 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 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 attorney before
commencing work or recording our Notice of Commencement.
s
Signature of Owner/Lessee/Agent 4SIgnature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY 01 COUNTY COUNTY OF ��
The forgoing instrument w s acknowledged before me The forgoing instrument was acknowledged before me
this day o20,I by this/ day of h_D 20 Z,§—by
(Name of person acknowledging) (Name of person acknowledging)
L �
( ature of Notary Public-State of Florida) 7ersontally
ure of Notary Public-�State'of Florida)
Personally Known OR Produced identification Known ``—�0R Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. """ Commission No. y'„„,,,,
S H014MANN w. SANDRA HDNMAN
','•P�p�.'�-� ida
Notary p'uttlic-5tate of Florida ;•'�;• ���� Norary Public-
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018
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sanded ihrouph Natloaal
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION., SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
CO.MPI.ETE
INITIAL$ '
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