HomeMy WebLinkAboutBuilding Permit Application 10/06/2015 12:35 IRC PLUMBING SERVICE INC. 772.696-3747 P 1
ALL APIptKABI.E INFO MUST BE COMKMD FOR AMXATION TO BE ACCEPTED
Date: ~• , J Permit Number.
Building Permit Application
014mnM and O v kpwnt Seivkes
BuiW"ow Colt ReQukr6m Drvai
,23W 16,19mia Avenue,Fort Pierce FL 34982
Phone:(772)462-2553 Fax:(7n)462-1578 Commercial Residential
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PERMIT APPLICATION FOR: To Selig from dropbox,click arrow at the end of line
PROf_OSED IMPROVEMENT U)CATION• .
Address: l rif f } F k-
tegal Description ,r U
Property Tax ID It• lb -�Otp f '-� f oo s Lot No.
Site Plan Name: Block No.
Project Name: --
Setbacks Front Back_ Right Side: left Side:
1DETAILED_DLWAIPTIONOFWORIL' ... ..
CONSTRUCTION INFORMATION:
'Adri�,onaTwor�c to or Wer i5 perm --t a [nap-pw.,
�}tyAC �-/Gas Tanksas Piping _Shutters Windows/Doors
ElElectric tldPiumbmg USprinklers Generator C]Roof
Tota!Sq.Ft of Coastrueticm: Ft.of First Floor:
Gust of Coition:S-�-_ .-,�......,. Eltilities Sewer O Septic Building Height:
OWNER/t.MEEz CONTRACTOR: . 9 t .
Name r d d i��h c1 itC. Area'r Name: L I z
address
31i 1 �f1� - b �"fl'l N i+l /"►!i Company rc-t, fuy)041 OL
State:bcl Address; ' ? '( ct+l .�
zip C,o&.�.�` 1 ' ----- Fax: City: ��1 U 4"rl Stater
Phone NO. lip Code: Fax:
E-Mali Phone No. (.A 1
Fill io fee§*M&TWI#101t1t/on next pop I If diffamd E-Mail: s 1Li a
f o dw Owner -12041 State or County Lkense: ���'� 0 ,-N a W�..�
M wdue of cu%vuetm is$zw or nb+'e.a W OIt KO tlatim of cows- w w"WA is"Kp*Rd,
10/06/2015 12:35 IRC PLUMBING SERVICE INC. 772.696-3747 P 2
SUPPLEMENTAL CONSTRumoN LIEN LAW 1NfoRWATKN
DESIGNER/ENGINEER: _Not Applicable 1lAOlt�GAGE COMf~�'
Name: Name:
Address: Addrew
�
city: State: 5tdte:.._.
Zip-, phone. Phone=
FEE SlMPtE TRtE HOU)ER; Not Applicable 13GNf1ING COMPANY:
Name: . Name
Address: Address:
City..
,
Zip: Phone• Phork:
I certify than no work or installation has commenced ptw w thew' wane of a peordt.
St.Lucie County makes no representation that is lZ a permit will acN+ori;!ti►e hd>fdex to Wild ��
which is in conflict wRh any applicable Nome 0*6ers Assotration rules.bylaws or ar�cwsr+uiwt brat m� AWY atm/-
Structure.Please consult with your Nome Owners Association and review your deed kw any restrk=Km
In consideration of the granting of this requested perms,l do hereto agree that(wi.in ad re WeM pe kwm dw not
in accordance with the approwed plats the Florida Building Codes and SL iluucie Cotm*v Am endrrwerd&
The follow)ng building permit appficatiom are exempt from undergoog a iW conctxroxy remw room adftwl+sr
atMsory structures,swimming Pools,fence3,walls.s4tti.Screen rowel and w4morlf uses to anotlw ne"w die flig use
WARNING TO OWNER:your failure to Record a Notice of rq"resiA in your oar s twice for
improvements to your progeny,A Notice of Commencement mst be recorded and posted on the Obsite
before the first inspection.it you intend to obtain financing,consult with lender or an attorney bef'or'e
commencing work or recording our Notice of Commencemerrt.
S
_Signature /lessee/AgentSTATI OF Sig tt� Cs�ntr nr/lirrer�se FtofOer
COUNTY OF GRID doon �T COUNTY STATE Of OA
The forgoing trestru ,-was adatowk*ed before me The f[ulplin f;�rtsrr�er .was� He
this"'t9"day of (al 1 • 20 the - 2i3�
(Name of person acknowledgmg) (Name of person adawwiedeitig)
fV_
k/71 l
(Signature a( P►ibk,-State of FWNU of Noewy Public.State of Rwida)
Pe+aorwliy Known
' on Produced Uk"dication � h Kwwn . �M'roMd ld�pp
Type of kleritifiCatron Prrsduced Tym at''P, dicatioit Produced
commosron No. _ ( C4n"++05" n
V.
ANE$RI1
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Revised 07/b5/20MY Co"Aeon arras"„ Weil
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