HomeMy WebLinkAboutBuilding Permit Application 10/07/2015 13:43 7724662417 SEACOAST SHEET METAL PAGE 02
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: �S
ttim„ - J RECEV°' OCT 0 71015
Building Permit Application
Planning grid Development Services
Building and Code Regulation Division
2300 Virginia Avenue;Fort Pierce FL.34992
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line JY eO.
P.
Address: 97V 311 c/n
Legal Description:
Property Tax ID#: X33 Y ` 04`QQ ®2- 00P" fj Lot No.
Site Plan Name: [clock No.
Project Name:
Setbacks Front Back: Right Side: . Left Side:
FS:CFtIP7.I:0.N:0• 111IO[ :r: •
. .. .UC•T16;
GO,NTR04""".
FC� iIVi' -
N::.I�I ;:
rtr a wor c to be ertormed un er t is permit—ch- c a I apply;
_HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers ❑Generator Roof
Total Sq. Ft of Construction: 5 . Ft.of First Floor:
Cost of Construction:$ /6J �p Utilities:12Sewer FJ Septic Building Height-
Name e f' �-p LName' JOHN V LANGEL
Address: X7111 a)1 °
��Unron R _ Company: SEACOAST AIC _
City:_ F-/ 'r"y— Z(/er? State:.EL Address: 2601 INDUSTRIAL.AVE 3
Zipcode, %� Fax: City_ FT PIERCE State:FL
Phone No. g�yf Vp Code: 3494E Fax: 466-3053
E-mail, Phone No. 466-2400
Fill in fee simple Title Holder on next page(if different E-Mail: TLSEA0OASTAIR@A0L.00M
from the Owner listed above) State or County License: CAC016446
If value 4f construction is$2500 or more,2 RECORDED Notice of Commencement Is required.
10/07/2015 13:43 7724662417 SEACOAST SHEET METAL PAGE 03
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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: Not 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.
5t.Lucle County 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 Rome 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 ma result in your paying twice for
improvements your property.A Notice of Commencement must be re ded and posted on the jobsite
before the firs inspectio if you intend to obtain financing,consult wit rider or an attorney before
commencingork or re rdi our Notice of Commencement.
Y s
_SignarFLORID
er/L see/Agent Signature of ntrartor/License der
STATE STATE FLORIDA
COUNc1 COUNTY OF"�����E
The fo oing instrument was acknowledged before me The forgoing instrume t was acknowledged efore me
this• day of._ L7 / 20 jby this 7 day of z0 —by
JOHN V 1 JOHN V LANQEL
{Na f person ackn I ging) (Nameo cknowledging)
(Si ture of ar a of Florida} (Signature o c-Staterb Iorlaa}
Personally n x duced Identification Personally 6tifl '
OR Pro�l4ed Identification
Type of identification Produced Type of Ide �hProducecl
Commission Mo. "'I'v"I's
TRACY seal) Co (seal)
KAY LANA ZP
�� GXAtR�S N'�'1=Fr4&ora, eof 'r jj� S�1S81 �fiFi4G
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REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION iae. LE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS