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HomeMy WebLinkAboutBuilding Permit Application Miranda Plumbing&AC 7728710863 p.2 ALL APPLIC E 1F MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date; ! Permit I�urnber: \54`� 03�1 9 RECEIVED SEP'21 2015 Building Permit Application Planning and DevelopmentServices Building and Code Regulotlon Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772; 462.1578 Commercial Residential PERMIT APPLICATION POR: To Select from dropbox, click here V c--\ PROPOSED INPROVEMENT LOCATIO Address: Or, Pat n , L1!r y�gal Desai tion: —i- &0 ' J Cd nc t?m I s fY o r Property TaxlD#: �J535' �d3— aQa�— 640— Co Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILE©DESCRIPTION OF.WORK: be y J 1 Lt� CONSTRUCTION.INFORIVIATIO.N: - . �tioor to be erformed under t is permit—check all appy: t{VAC Gas Tank Das Piping _Shutters ❑Windows/Doors Electric Plumbing []Sprinklers Generator Roof Total Sq. Ft of Construction: Sci. Ft.of First door: Cost of Construction:S vt% Utilities:1:1Sewer ED Septic Building Height: OWNERjIESSEE: CONTRACTOR; Name, Nam C' 1 At- Addres 14 I e`= Company: tfGCl1 ,CL `Y� City: !'^ I ��.0 State; Addrjs: Zip Code: 0 F" Cit... Stater. Phone No. if� Zip Code:` 4CN�iS� Fax, E-Mail: ( {Q0,V 'i rr'} fu'�L�i+ . ti r Phone No. �.=r, Fill in fee simple Title Halder on next page (if different ` E-Mail: C , t�('Q 6 Pl wC l C, from the Owner listed above) State or County License:4 d if value of construction Is$2500 or more,a RECORDED Notice of Commencement is required. Miranda Plumbing&AC 7728710863 p.3 i i SUPPLEMENTAL C `NSTRUCTION LIEN-LAW INFORMATION::: DESIGNER/ENGINEEW Not Applicable MORTGAGE COMPANY: _Not Applicable Name; Name: Address: I Address: City: I State: City: State: Zip: Phone: Zip: Phone: I FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: �NotApplicable Name: Name: Address; i Address: City: l city; Zip: Phoie: Zip: Phone: OWNER/CONTRACTOiR 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 commenced prior to the issuance of a permit. St.Lucie County makes no 'representation that is grant:ng a permit will authorize the permit holder to build the subject structure which is in conflict with any applicab'e 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 consideratlon of the granting of this requested permit,l do hereby agree that I will,in all respects,perform the work in accordance with the applroved plans,the Florida Building Cosies 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 befor�Ae first inspection. If you intend to obtain financing, consult with lender or an attorn'ey before com.rhenii nK work or decordi ng your Notice of Commencemen Signature of Owner/Agent/Lessee Signa re_dfZontractor/License Ho;der --------------------- STATE OF FLORIDA j I t STATE OF FLPfill' A L COUNTY OF:� ! ;�.c COUNTY OF Q-Z� The for__&p,�g instrument was a- 0w..led ed before me,+`��e;Na The forgoing instrument w�acknowledged before me ;�,> ':r this��`clay of _,20) 6y ? '= this/. ay of.SP �i7 -t� ,z4®�y 1AD 7Y'ra nun` (Name of person ackpovO ging (Name ofiperson aSknowledging) �i� y /��. �'�Fi. '/ •J i ��I,.'! / z m •Ik f�• /�..�•• -'-' !;f/ lj !: O N R1 a ( lgnature of Notary Public-SSate 6f l lorida) g o c `(Signature of Notary public-State of Florida) �, a Personally Known ' OR Produced Identification Personally Know OR Produced Identification Type of Identification Pro used Typeof Identification Produced a3� Commission No. f f (Seal) Commission No. r (Seal) i I Revised 07/1512014 .I REVIEWS FRONS ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE I COMPLETED I