HomeMy WebLinkAboutBuilding Permit Application 10/16/2015 14:57 7724662417 SEACOAST SHEET METAL PAGE 02
ALL APPLICABLE
yINFO /UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: / !� Permit Number: �G 7
Building Permit.Application
Planning and DeveloPm en t Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462,1553 Fax:(772)462-1579 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line AleGh
,1
zi
Address:
Legal Description:
propErlyTax Ib#: ��Z�� r�j�+ra- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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HVACna wort o e
orme un er t rs permi —c ec aappy:
Gas Tank ❑Gas Piping _Shutters 0 Windows/Doors
Electric 0 Plumbing Sprinklers Generator L1 Roof
Total Sq. Ft of Construction: _ SFt.of First Floor:
Cost of Construction:$ �� , Q u� __— Utilities:n Sewer[]Septic Building Height:
ow
Name `Ver �? PM Name: JOHN V LANGEL
Address' 15( x' Company: SEACOAST AIC
City: 50ar n
State: Fl– Address: 2601 INDUSTRIAL AVE 3
Zlp Code: j Fax: __ City: FT PIERCE State:FL
Phone No. 77.2-- 7 a Zip Code: 34946 Fax: 466-3053
E-Mail: Phone No. 466-2400
Fill in fee simple Title Holder on next page(if different E-Mail: TLSEACOASTAIRQAaI..GOM
from the owner listed above) State or County License: CAC016446
If value'of construction is$2S00 or more,a RECORDED Notice of Commencement is required.
10/16/2015 14:57 7724662417 SEACOAST SHEET METAL PAGE 03
Ui?f L NCtENTAL;C.C)N l UC1'lt .N:.. C N LA fNFQl3fVlATCQ!!!
DESIGNER ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address;
City: State., i 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,
St.Lucie 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 Rome 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 Build(ng 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 nonresidential use
WARNING TO OWN R:Your failure to Record a Notice of Commencement may result in your paying twice for
improvemer to
ur property. Notice of Commencement must be reco ed and post d on the jobsite
before the first in ection. you ntend to obtain financing,consult with i der or an at rney afore
commencingwar or reco in u otice of Commencement,
r
r
(�f
signature of Owner/Lessee/Agee signature of Co ctv e-nse Ho r
STATE OF FLORIDA STATE OF ORIDA
COUNTY 0Fs'rLucia COUNTY OFsTLmis
The for oing instrument was acknowledged before me The forgoing instrum nt was acknowledged before me
this day ofiG 20 L!�—by this,L� day of 20 by
JOHN NGEJOHN L
(Na a of p son ackn ledgln (Name ef p r acknowledging•)
(Signature otary Public- t• orida) (Signature of Nota u Ilc-State of Flori ) _
Personally Known x O Produced Identification _ Personally Known OR Produced Identification
Type of Identification P _,,— T d
3M",?U�
s '`....
TR
Y L.ANGEL. fir s TRACY KAY LANGEL
Commission No. flim o?s1'+M eal}
MYG SIGN#FFt48472 ,�: P148o7?
>rxP1RES August 30,2o18 y°!t.oTN ` BXPtR $August$o,2o1a
(40 MR-0i63 Flortdallotaryseiu;ce.corn totldttArotd ServiCe,com
ReYised 07115/20
REVIFWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS