HomeMy WebLinkAboutBuilding Permit Application 10/20/2015 09:56 7724662417 SEACOAST SHEET METAL PAGE 02
ALL APPLICA13LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /U" ~!'J Permit Number: O�
Building Permit Application
Planning and Development Services
Building and code Regulatlon Division
2300 Virginia Avenue,Fbrt Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT/APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRQPOSED IMB
Address: DA CPA Ye.
Legal Description:
Property Tax ID#:_r3k) 0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front^ Back: Right Side: Left Side:
TAI;CED D SCR.
ke
Additio wor to MsTank
rme un er t is permit—c ec c a appy:
HVAC []Gas Piping _Shutters Windows/Doors
Electric L1PlumbingSprinklers a Generator a Roof
Total Sq. Ft of Construction: Sq. of First Floor:
Cost df Construction:$_ G76���1P Utilitles: Sewer aseptic Building Height:
i .Wl PR I.ESi:�EE: ,..,:...
Name V r? din Name: JOHN V LANGEL
Address: ' kCompany: SrrA COAST A/C
City: "il,)i 1, State: Address: 2601 INDUSTRIAL AVE 3
Zip Code:_' Fax:_ City rT PIERCE State:l"L
Phone No. Zip Code. 34946 Fax. 466-3_053
E-Mail: Phone No. 466-2400
Fill in fee simple Title Holder on next page(if different E-Mail: TLSEACOA$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.GiRPL Iti i TAL=C{pNST t1CTrt ,N L( 1U.L1 i111 IN1i OA.-IATI(3.(
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: w,Not Applicable
Name: Mame:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
i certify that no wont or installation has commenced prior to the issuance of a permit.F
St.Luciepuntv 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 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 Building Codes and St.Lucle County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,sw ming pools fences,walls,signs,screen roams and accessory uses to an her non-residential use
WARNING TO OW ER:Your ure to Record a Notice of Commencement may res in your p iqg twice For
improvements to our prope y.A Notice of Commencement must be record and post on the jobsite
before the first i pection,i ou int d to obtain financing, consult with len r or an at hey before
commencing w k or recipor to o otice of Commencement.
s
Signa'tur Owner/Lesse Agent Signature of Con, ctor/License ider
STAT F FLORIDA STATE OFF RIDA
COU Y OFsTLUCIE COUNTY OPsiLucM
The fooing instrument was acknowledge��efore me The for oing Instrume t was acknowledge efore me
this day of Dr_. _ zp by this day of z0 by
JOHN V I ANGELS .1OHN V LANGM.
(Name Kpirson acknowledging) (Name of perso nowledging)
(Signature of No Pu - (Signature of Notary Pub" ate of florid
Personally K OR d d Identification Personally Know _OR Produced ification
Type of identification Produced Type of Identif' atlan oduced
Commission No, — (Seal) Commission No. (Seal)
RACY KAY d,APJGEL `�
�� .•. d-AAiG�L
+A �ACY KA'y
Revised 0 5 MY COMMISSiON#FF9+iitc72 ��'� i" i41Y CoMMiSslO�(#>F}a8o7
..,. Wleu{80;; o ust 30.2078
REVIEWS too a Ft r! hilae, n VISOR ALA to iyk�eTet�,RTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW ft _ REVIEW
DATE
COMPLETE
INITIALS