HomeMy WebLinkAboutBuilding Permit Application (2) 10/20/2015 09:56 7724662417 SEACOAST SHEET METAL PAGE 02
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �U 240 /J Permit Number:
vfl,—0000,11111,11110' 11 W li
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,i=ort Pierce FL 34982
Phone:(772)462-1,553 Fax: (772)462-1578 Commercial Residential
PERMIT/APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPQSEQ IM'R r
FI;C��/�f1�,I�r1I.1T:•tOJLp'TI.C� , .: •
Address: �lZj�k DAlIIA ,AYE. ^�
Legal Description:
Property Tax ID#:_139J- !11" "/-0670 v0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front^ Back, Right Side: Left Side: -
,_. ., .
TALLE.b' ►0CR[PT.- �.N:•dF- O'Et.l�
tr l,l'4 @ � r k� `j.� 7/x'1 �i2 ���' (�+�W /'�� • �//►•
Ac�lcl
itlo
pl wor to• e e orme un ert is permit—c etc a appy:
_HVAC Gds Tank ❑Gas Piping _Shutters Windows/Doors
®Electric ❑Plumbing []Sprinklers 0 Generator El Roof
Total Sq. Ft of Construction: S Ft.of First Floor: _
Cost df Construction:$_ d06��I�4" Utilities:Li Sewer Lseptic Building Height:
,
Name V
RvdYn Name: JOHN V LANGEL
Address:, (�-�d4� �_ W 122• ' ;�Vr! Company: SEA COAST A/C
City: r��M State•, Address: 2601 INDUSTRIAL AVE 3
Zip Code:_' Fax: City: rT PIERCE State:Fl,
Phone No. Zip Code. 34945 Fax. 466-3_0.53
E-Mail: Phone No, 466-2400
Fill in fee simple Title Holder on next page(if different E-Mail: TLSEACOA$TAIR@AOL.COM
from the Owner listed above) State or County License: CAC016446
if value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
10/20/2015 09:56 7724662417 SEACOAST SHEET METAL PAGE 03
S.URP,LNiEN AL=C STi2ClCT�
Y piu r,N � vu ii i Tia:r
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: i 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.
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 Home Owners Associatlon 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,1in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and 5t.Lucie County Amendments.
The following building permit applica't'ions are exempt from undergoing a full concurrency review:room additions,
accessory structUres,sw ming pools fences,walls,signs,screen rooms and accessory uses'l'o an her non-residential use
WARNING TO OW ER:Your f ure to Record a Notice of Commencement may res in you7noe"�
' g twice for
improvements to our prope y.A Notice of Commencement must be record and pashejosite
before the first i peCtion, I ou int d to obtain financing,consult with len r Qr an atafore
commencingw k or reG r In yo otice of Commencement.
",A,-VA -A
s
Signator owner/Les'" Agent Signature of CYalDA
ctor/License Ider
STAT F FLORIDA STATE OFF
COU OFSTLUME COUNTY OFsrLucir
The fo ging Instrument was acknowledgecljefore me The for Ding Instrume t was acknowledge efore me
this day of dt, 2p Lby this day of Z4 by
JOHN V 4ANGEL'� JOHN V LANG0.
(Name p rson acknowledging) (Name of perso nowledging)
5i nature of No Pu - (Signature of Notary Pub ate of Florinification( g, y#r}—�—
Personally K OR d d identification Personally Know _OR Produced
Type of identification Produced Type of Identif' ation oduced
Commission No. (seal) Commission No. _. (Seal)
TRACY FLAY LANGEL � :4 `�+' 'TRACY KAY I ANr.EL
Revised 0 15 MY COMMISSION#FF14807?., 1* MY 40MMiSSIQI�#FFt48o7
(407)39 U U8130,2018 —
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